July -August 2015

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Volume VI || Issue II || July-August 2015

The Gateway to Health & Medical World

Vol. VI Issue II

July-August-2015

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SPEAK

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Editor's Speak

Editorial After Witnessing the horrendous status of patients, the conscience keeps on reviving time and again. Some call him an apettetic person after seeing plane facial expression because he gets used to but the fact in there in more empathy which he expresses in the operation theatre as the medical oath keeps on resonating

Some people say life saver ,some consider him next to God ,and some at times curse him when things go wrong .He is no one but a Doctor, who puts in the best efforts for the savior of the creation.

Volume - VI Issue - II July-August 2015

Editor Chief Editor Editorial Advisor

Dr. Pradeep Bhardawaj GP Capt. (Dr.) Sanjeev Sood Dr. Sharad Lakhotia Afzal Kamal

Asst. Manager

Ashi Tiwari

Corporate Communication

Cheif Correspondent

Being a doctor adds up more responsibility towards a nation and society. Medical Industry serves 24 hours a day, in order to cater the needs of the patients around the world. People at times forget that Doctors are just an operator not a healer. People build up more expectations and end up with disappointments, at times and the aftermaths are often followed by a stereotypical indecent behavior, which kind of generalize the whole medical fraternity due to some black sheep's , who defy the moral high grounds and the code of practice. India is excelling with an increasing pace on a medical platform, and aspiring doctors are growing in numbers. So in order to motivate and boost the morale of Doctors and the aspirants, proper initiatives and mass awareness should be done in the public forum, which should disseminate the correct medical knowledge and must be Doctor centric.

Subscribtion & Cirrculation

www.m e d e g a t e t o d a y. c o m July-August 2015

Dr. ma Kamal

National Head

On this Doctors Day Medgate today salutes to all the doctors across globe. So it's time now to acknowledge the contributions and achievements of this medical fraternity working around the globe on Doctors Day.

Have an insightful reading Your suggestions are most welcome! E-mail : editor@medgatetoday.com Website: www.medgatetoday.com

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Reader's EXPERT Contents VIEWS Voice

INTERVIEWS

News Secukinumab shows promise for psoriatic arthritis China rejects Gilead's Patent Application for Hepatitis C drug Solvadi, Striking Blow to Gilead's Global Strategy

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Microalgae may be New Natural Source for Antibiotics 14 Fortis Escorts Heart Institute (FEHI) adjudged Best Single Specialty Hospital in Cardiology

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International Society for Magnetic Resonance in Medicine 2015, Toronto

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Grand Celebrations on International Day of Yoga

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World No Tobacco Day

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Medical Nonwoven Disposables Market in Asia-Pacific to Reach $3.3Billion by 2020 - Projects

Dr. Jagdish Prasad Director General, Health Services, Govt. of India

Guru Prasath Director Business Development / Marketing Messe Duesseldorf India Pvt. Ltd.

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Study Suggest Stem Cell Therapy improves Quality of Life in Multiple Sclerosis Patients 24 India’s Youngest Kidney Transplant at Asian Institute of Medical Sciences

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New drug brings hope for children with leukaemia

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K. Sundarajan Project Director, Medicall

Doctor Speak

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Kick the bud for better tomorrow!

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Computer Navigation Technology: Changing the Face of Knee Replacement Surgery

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World Hypertension Day

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Walking up to Social Networks

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Hematopoietic Progenitor Cells (HPC) Novel parameter in Hematology Analyzer

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Kidney Transplant: Blood Group Matching no More a Barrier

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Managing Asthma in Children

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Anjan Bose Dr Aparna Jaswal Secretary General Senior Consultant Electrophysiologist, Health Care Federation of India Fortis Escorts Heart Institute (NAT HEALTH)

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Expert Views Smart Wound Healing Through Andoird App

Kawal Arjani Managing Director, TuffT Surgical Instrument

DR. Sanjiv Saxena Senior Consultant & Head Department of Nephrology, PSRI Hospital

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Dr. Rajiva Kumar Child Specialist, Muzaffarpur


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NEWS Update

Secukinumab shows promise Big step towards H. pylori vaccine for psoriatic arthritis

A clinical trial of secukinumab, recently PBS-listed for plaque psoriasis, suggests it may also benefit patients with psoriatic arthritis. The phase 3 double-blind randomised clinical trial (FUTURE2) compares three different doses of secukinumab with placebo, in nearly 400 patients at 76 centres across four continents, including Australia. The patients had active psoriatic arthritis, despite previous treatment. Treatment was by weekly subcutaneous injection of the human anti-interleukin-17A monoclonal antibody for four weeks, with further injections every four weeks thereafter, the authors say. At 24 weeks into treatment, 54% of patients receiving the highest dose of secukinumab (300mg) met the primary endpoint of at least a 20% improvement in the American College of Rheumatology response criteria (ACR20). This compares with 51% of patients on a 150mg dose and 29% of patients receiving a 75mg dose. In contrast, 15% of participants receiving placebo achieved ACR20. The safety data “seem reassuring”, say the authors of a linked comment in the Lancet. Rates of adverse events were similar in the treatment and placebo arms, they point out. There were, however, 11 cases of candidosis, all in patients receiving secukinumab. This is not surprising, given that Interleukin 17 is important in defence against this organism, the comment authors say. All cases of candidosis either resolved spontaneously or responded to oral therapy. About two thirds of the patients in the trial had not been treated with TNF-alpha inhibitors and they had a better response to secukinumab than those patients who had received, and failed, treatment with up to three different TNF-alpha inhibitors. Overall, patients seemed to fare almost equally as well on 300mg or 150mg doses. But this was not the case in participants who had failed to improve with TNF-alpha inhibitors, who did better with 300mg. 10

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Chinese researchers have developed a vaccine for helicobacter pylori (H. pylori) which has a 72% efficacy rate within the first year, according to a study published in The Lancet. They have conducted a study involving 4464 children that shows 14 of those randomised to the vaccine experienced infections in the first year, compared with 50 infections for those on placebo. After three years follow-up, the vaccine group reported an additional 16 infections and the placebo group 35 infections, with efficacy dropping to 55.8%. The children aged 6-15 were given three oral doses in the first year. The researchers say their vaccine was created with three doses of a fusion protein made up of B subunits, H. pylori urease and heat-labile toxin of Escherichia coli. “The sustained vaccine protection against H. pylori infection up to three years suggests that this vaccine could substantially reduce the incidence of H. pyloriassociated gastritis, gastric ulcer, duodenal ulcer and gastric adenocarcinoma.

Gastroenterologists raise concerns over biosimilars A law that may allow a pharmacist to substitute a biologic for a biosimilar without clinician input is causing concern among gastroenterologists. Professor Jane Andrews, chair of the Australian Inflammatory Bowel Disease Association (AIBDA), says there is little data to support the safety and long-term efficacy of switching between an originator molecule and its biosimilar. The exception is in oncology, where there is data to support the safety and efficacy of multiple switches for one biologic and its biosimilars, she says. “In the gastro area, the biologics used are huge molecules and we don’t have any clinical data on switch and reswitch and no easy way of monitoring patients in real time,” she says. She says the concerns have been discussed at a biosimilar consultation meeting with the PBAC. Ideas raised at the meeting include establishing a registry that would monitor the longer term efficacy and safety of biologics and biosimilars in a particular disease.


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NEWS Update

Indigenous Test to Monitor Cerebral Palsy Gets Global Recognition evaluation and monitoring of CP patients following treatment. It will also help in better disease management and course correction as it covers all the known symptoms that are important to assess patient with CP.”

GMFCS scoring system, measured in grades, poses certain limitations as it is based only on self initiated tudy published in International Archives of movement, especially ability to walk and stand. The Medicine proves that the unique indigenous distinction between first two levels of GMFCS is unclear, tool NFS can be used globally to assess the mainly for children below the age of 2 years. improvement in patients with Cerebral Palsy “The other advantage of using NFS is that scoring is Doctors at Nutech Mediworld, the world’s only numeric which means grades can be added or subtracted, human embryonic stem cell therapy centre based in thus revealing even the slightest improvement in the India, have demonstrated the effectiveness of a tool to patient. While NFS tells the condition of a case from bad track improvement of Cerebral Palsy (CP) patients after to good, GMFCS (a single score assigned on the basis of undergoing treatment. The tool, the first of its kind, tracks age and motor function) classifies CP into five levels from over 32 parameters to provide accurate assessment of good to bad, “added Dr Shroff. the progress of the disease as compared to the existing The study was conducted on CP patients who method of screening. undertook human embryonic stem cell treatment The result of this new study tool, called Nutech Dr J K Bharthakur Co researcher said, “The facility Functional Score (NFS), developed by Dr Geeta Shroff, has been treating patients with CP since 2000. While has been published in the International Archives of Medicine (June, 2015), an open access international grading the CP patients with existing scoring system, the doctors felt it difficult to grade several parameters. This medical science and clinical practice journal. led to the development of NFS.” NFS can assess all known symptoms of CP that remain CP is a non-progressive disorder that occurs as a far from assessment using the presently used testing system called the Gross Motor Function Classification result of the damage to the brain of a foetus and newborns. System (GMFCS). These include feeding, indication, Its signs and symptoms, such as spastic muscles, poor epilepsy, toilet training, drooling, mathematical skills, balance and gross motor delays remain lifelong and hearing, vision, commands, smiling, constipation, patient is subject to life with limitations. It is estimated to recognition/awareness, eye contact, aggression, speech, affect 3 per 1000 live births in India. breathing difficulty, defence mechanism and swallowing. The treatment of CP with human embryonic stem As opposed to GMFCS, NFS scoring system is not only cell therapy has emerged as one of the most effective and more sensitive towards infants but can also be used to safe solutions in recent years. This treatment has aided in assess patients aged above 18 years. reversing and helping to cure the signs and symptoms of As per Dr Geeta Shroff, Founder and Medical CP. At Nutech Mediworld, patients from as far as Iceland Director, Nutech Mediworld, “Our test will help in better and Australia come to undertake treatment.

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NEWS Update

CHINA REJECTS GILEAD’S PATENT APPLICATION FOR HEPATITIS C DRUG SOVALDI, STRIKING BLOW TO GILEAD’S GLOBAL STRATEGY Citing Evidence from I-MAK’s Patent Challenge, China’s Patent Office Finds Key Sovaldi Patent Fails Legal Requirements, Threatening Gilead’s Strategy of Pursuing Illegitimate Patents Treatment Advocates Vow to Continue Patent Challenges to Get Millions of People Life-Saving Drugs In a decision that has major implications for the global fight against a growing hepatitis C epidemic—and pharmaceutical corporation Gilead’s (NASDAQ:GILD) pursuit of illegitimate patents that block millions of people from getting the treatment they need—China’s State Intellectual Property Office (SIPO) has rejected a critical patent application for the hepatitis C medicine sofosbuvir, marketed as Sovaldi. Despite Gilead’s repeated efforts to refute evidence submitted by the Initiative for Medicines, Access & Knowledge (I-MAK’s) in its patent challenge in fall 2014, SIPO found that a key patent application that would have strengthened Gilead’s grip over sofosbuvir was based on obvious techniques and did not meet the legal criteria required for a patent. SIPO’s rejection threatens Gilead’s global patent strategy for sofosbuvir and paves the way for other countries evaluating Gilead’s unjustified patents. Using unjustified patents, Gilead is demanding a price out of reach for most people – up to $1,000 per pill in the U.S. and similarly exorbitant pricing in developing countries where the most people with hepatitis C live. “The Chinese patent office’s rejection of this sofosbuvir patent sends a clear message that when presented with facts, countries are standing up against Gilead’s pursuit of unjustified patents that create barriers between people and life-saving treatment,” said Tahir Amin, I-MAK co-founder and director of intellectual property. “We hope that other countries’ patent offices do the right thing, reserving patents for drugs proven to be new and non-obvious and helping millions of people get the medicine they need to survive.” The ruling comes after non-profit attorneys from I-MAK announced a series of coordinated patent challenges against sofosbuvir in five countries, including a patent challenge filed in fall 2014 in China—the first patent challenge ever filed by a civil society group in the country. 14

www.m e d e g a t e t o d a y. c o m July-August 2015

The decision by the Chinese patent office agrees with I-MAK’s challenge that the “prodrug” used in sofosbuvir, which activates the otherwise inactive base compound in the body, was developed using previously published techniques that have been used repeatedly in other antiviral and HIV/ AIDS drugs. While Gilead still retains a patent to the base compound in sofosbuvir, the prodrug rejection significantly weakens Gilead’s reliance on illegitimate patents to grow profits and supports other countries’ fact-based evaluations of Gilead’s patent applications. “China’s rejection of the sofosbuvir prodrug patent marks an important step toward ensuring Gilead cannot claim existing public knowledge as its own,” Priti Radhakrishnan, I-MAK co-founder and director of treatment access.“Unjustified patents create barriers that stand in the way of people getting the medicine they need in China and in countries around the world. Treatment advocates and attorneys in an escalating global movement will continue to challenge illegitimate patents to ensure more people can overcome a deadly disease and lead healthy lives.” China serves an essential role in the global pharmaceutical drug supply chain, providing roughly 43 percent of the raw materials used to produce anti-infective medicine for the world, according to the World Bank’s Human Development Network. China and India are both home to the majority of the world’s generic drug manufacturers, which, in turn, supply low- and middle-income countries with affordable drugs. Removing all illegitimate patents for sofosbuvir in China will help open the supply of raw materials to manufacturers around the world and get the drug to the 50 million people with hepatitis C in middle-income countries who currently cannot get the medicine they need to get well.


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NEWS Update

Microalgae may be New Natural Source for Antibiotics

P

hycologia – Bacteria are resourceful, and their growing resistance to antibiotics has drawn attention and caused concern worldwide. There is an urgent need to find new sources of antibiotics. Among other options, scientists are turning to natural compounds from relatively unexplored microorganisms.

Screening programs are being used to search for potentially useful strains of these microalgae.

Researchers have found that microalgae can survive in and adapt to a range of harsh environmental conditions. Changes in temperature, light, pH, salinity, and the availability of nutrients have been extensively studied for The authors of an article published in the current their effects on microalgal growth. The adaptability of issue of the journal Phycologia looked at one such the microalgae suggests that they can develop resistance group of microorganisms: microalgae. Researchers against a variety of stresses. have investigated only a few species so far, but work Microalgae also produce compounds that can stand up to with freshwater microalgae collected from remote, the activity of some of the bacteria that sicken people. scientifically unexplored regions in northern Canada has When their environment changes, these microorganisms produced several promising candidates for antibiotics. produce even more antibacterial compounds. This makes Microalgae are found everywhere: in lakes, rivers, garden them a potential resource in manufacturing antibiotic ponds, even swimming pools. Yet little research has drugs. Advances in technologies that can detect, purify, focused on them as potential antibiotics. Most antibiotics and identify the antibacterial compounds produced used today were created from bacteria, and the increasing by microalgae only increase the possibilities for new resistance of the bacteria has prompted research into antibiotics. synthetic variations. The authors of the current article The authors concluded that the range and variety of argue that microalgae may be another potential source of microalgae, as well as their antibacterial activity, could resistance-proof antibiotics. make them an important source of new antibiotics. Their The authors give an overview of some of the research ability to survive and adapt to a range of environments may on microorganisms as antibiotics. They focus on the be highly valuable to drug manufacturers. Still, there are antibacterial activity of cyanobacteria and eukaryotic no commercially available antibiotics from microalgae. unicellular algae, collectively referred to as microalgae. More research is needed into these microorganisms to take advantage of this “untapped� source.

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NEWS Update

Fortis Escorts Heart Institute (FEHI) adjudged Best Single Specialty Hospital in Cardiology Wins ICICI Lombard & CNBCTV18 India Healthcare Award for Third year running India’s celebrated hospital dedicated to cardiac care, has won the prestigious India Healthcare Awards, 2014 for the Best Single Specialty Hospital in Cardiology for the record third year in succession. The award was presented by Mr.ShripadYessoNaik, Union Minister of State (Independent Charge), Ministry of AYUSH and Minister of State, Health & Family Welfare to Dr. Ashok Seth, Chairman, FEHI at a felicitation ceremony held in the capital.

Dr. Ashok Seth, Chairman, Fortis Escorts Heart Institute, Delhi, said, “We have been delivering the gold standard heart care in India for years and continue to strive to deliver newer, better and safer treatments to manage our patients. I am proud of all at Fortis Escorts Heart Institute who have harboured and elevated this passion for excellence to a ‘mission’. Today, we are indeed very proud to have the distinction of being amongst the top institutes of Cardiac Sciences in the world. We are delighted to receive this prestigious award. This is the third time running that FEHI was adjudged as It is a testimony to our ‘mission of excellence’ and instils the Best Single Specialty Hospital in Cardiology ahead of greater responsibility and determination to deliver our many prominent hospitals in India. The award identified very best to our patients.” FEHI as the winner among tertiary care institutes and was recognised as the centre of excellence in a focused single Dr. Somesh Mittal, Zonal Director, Fortis Escorts Heart discipline of cardiology. Institute,said“This is a proud moment for the FEHI team that has worked tirelessly to provide outstanding patient TheIndia Healthcare award is widely acknowledged care and has achieved clinical excellence. We perform as India’s most authoritative award in the healthcare more than 14,000 procedures annually. Our infrastructure industry and is jointly instituted by ICICI Lombard and in providing cardiac care is one of the best in Asia withthe CNBC TV18. The winners were selected after IMRB largest Cardiac Catheterization Lab and a dedicated International, India’s leading research agency, adopted a Electrophysiology Lab. The team is happy to receive this robust multi-phase methodology that shortlisted India’s award and we will continue to raise the bar in the delivery finest healthcare providers. The winners were selected of superior patient care.” by a distinguished panel which included prominent individuals from the industry and academia. 18

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NEWS Update

International Society for Magnetic Resonance in Medicine 2015, Toronto

New 7 Tesla MRI research system ready for future clinical use use. As a result, with Magnetom Terra, siting of a 7 Tesla • First ultra-high field scanner with all components MRI systembecomes much easier and its location in a clinical environment becomes feasible. Combined with the designed, built and serviced by Siemens Zero Helium boil-off technology, Magnetom Terra improves • New actively shielded system generation with 50 percent the lifecycle costs of ultra-high field MRI. lighter magnet and zero Helium boil-off to enable easier Magnetom Terra increases the potential for translating sitting and lower operating costs cutting-edge research capabilities into future clinical • Dual mode functionality for easy switching from research application –for anatomical, functional or metabolic MR modes to specific clinical protocols imaging. This specially designed 7Tesla technology makes • Expanded RF architecture with up to eight transmit and this possible by offering: up to 64 receive channels • Up to eight channel parallel transmit technology •

Identical software platform as Siemens latest flagship 3Tesla MRI systems for consistent usability

World’s first 7 Tesla research system ready for future • Up to 64 receive channels for higher coil density in clinical use with planned CE and FDA authorization to the field of view to achieve higher acceleration factors, market for selected neurological and musculoskeletal higher signal-to-noise ratio and higher spatial resolution, MRI applications and a better coverage of the body regions of interest.

for selective excitation and higher homogeneity in challenging body regions such as cardiac and abdominal.

“I am extremely proud to announce the introduction of our • new 7Tesla scanner Magnetom Terra . It is the first 7 Tesla MRI scanner fully designed and manufactured by Siemens, with a completely new designed 7 Tesla magnet in its core”, said Dr. Bernd Ohnesorge, CEO Magnetic Resonance at • Siemens Healthcare. “Now, Siemens is the only company to manufacture acomplete human ultra-high field MRI system fully in-house.” For The Magnetom Terra 7Tesla MRI system is designed to translate cutting-edge MRI research results into clinical application, and it is the world’s first ultra-high fieldresearch system ready for future clinical use with planned CE and FDA authorization to market for selected neurological and musculoskeletal MR imaging applications. The Dual Mode functionality allows users to switch from cutting-edge research modes to specific clinical protocols in less than ten minutes. The new 7Tesla MRI system provides the whole range of cutting-edge 7 Tesla research functionalities, and is based on the latest software platform syngoMR E11, identical to Siemens’ latest flagship 3 Tesla MRI systems,to enable consistent usability and protocol exchange. Magnetom Terra’s new actively shielded magnet is the lightest 7Tesla whole body magnet in the world– 50 percent lighter than previous actively shielded 7 Tesla magnet generations. This is the result of a multi-year engineering project at Siemens Magnet Technologies in Oxford, capitalizing on the long-term experience of the team in the design and manufacturing of state-of-the-art 3 Tesla magnets for clinical

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High gradient strength of up to 80 millitesla per meter (mT/m) and a fast gradient switching rate of up to 200 Tesla per meter per second (T/m/s) for advanced studies with diffusion and functional MR imaging. The latest Siemens software platform syngoMR E11 identical to Siemens’ latest flagship 3 Tesla MRI systems such as Magnetom Skyra and Magnetom Prisma.

specific clinical areas, Magnetom Terra is prepared for future clinical use with planned CE and FDA authorization to market of the system and the corresponding local coils: • Gettingbetter insights into the musculoskeletal system through unprecedented high isotropic spatial resolution of 0.2 mm. • Imaging brain tumors and irregularities in the brain’s metabolic processes. • Visualizing neurodegenerative diseases such as Alzheimer’s disease, epilepsy, schizophrenia and multiple sclerosis. “Based on our long-standing experience and the largest innovation network in human ultra-high field MRI, Siemens is committed to furthergrow the footprintof 7TeslaMRI in research and clinical application”, explained Dr. Bernd Ohnesorge. “I am confident that our Magnetom Terra will helpexplore new territories in MRI research and at the same time it’s the world’s first 7 Tesla scanner designed for clinical use.”


NEWS Update

Grand Celebrations on International Day of Yoga

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he Ministry of AYUSH is all set for the grand celebrations of the first ever International Day of Yoga to be celebrated world-wide on 21st June 2015. An hour-long programme will be held at Rajpath on the D- Day starting at 6.40 AM and will be attended by Hon’ble Prime Minister Shri Narendra Modi along with Cabinet Ministers, Minister of States, MPs and also Diplomats/ foreign nationals. In all, over 35000 people are expected to take part including students, NCC Cadets, CRPF & Yoga Institutions.

International Day of Yoga in a big way. All States have been requested to organize similar events at State / District /Panchayat Hqrs by performing asanas from 7 AM to 7.35 AM. Over 11 lakh NCC Cadets will perform according to Common Yoga Protocol and about 9 Lakh members of Armed Police Forces will perform in their respective field units.

One NGO for each of the 651 Districts have been invited for Yoga Training for one month so that they This was announced by the Hon’ble Minister of could be ready for the demonstration and Seminar on State(I/C), Ministry of AYUSH Shri Shripad Naik during 21.06.2015 the joint press conference on International Day of Yoga There would be live telecast and webcast of the event here today. at the Rajpath. Given the expected large participation at Department of Post is bringing out Stamp on the one place, the Ministry has applied to Guinness World International Day of Yoga and M/o Finance is bringing Records for “Largest Yoga Demonstration/ Class at single out coins of the denomination of Rs. 10 and Rs. 100. Both venue”. the stamp and coin will be released on 21st June 2015 i.e the International Day of Yoga, announced Smt. Sushma A 20 second video animation spot on the logo has been Swaraj Hon’ble Union Minister of External Affairs prepared which is being telecast over Doordarshan and during the joint press conference on International Day of other Private C&S channels across the country. A booklet on Yoga Protocol and a 33 minute DVD of Aasanas which Yoga here today. will be performed at the Rajpath of the D-Day has also The Minister said that out of the total of 177 countries been prepared by the Ministry of AYUSH. which have given co-sponsorship, 47 countries are from Organisation of Islamic Countries. They have Later, the Minister of State(I/C), Ministry of AYUSH Shri co-sponsored the event and expressed their desire to Shripad Naik urged the common man to start practicising participate in the yoga sessions being organised in the Yoga and contribute in the celebrations of International Yoga Day on 21st June, 2015 and support the mission of Indian Missions. our Hon’ble PM Shri Narendra Modi. AYUSH Ministry has written to States to celebrate w w w.medegatetoday.com July-August 2015

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NEWS Update VIEWS

World No Tobacco Day Stop illicit trade of tobacco products Tobacco kills nearly 6 million people each year, globally. Unless we act now, the epidemic will kill over 8 million people every year by 2030. More than 80% of these preventable deaths would occur in low and middleincome countries. Countries are constantly defining ways to curb tobacco consumption. Tax and price policies are widely recognized as most effective for reducing demand for and consumption of tobacco products. These measures together with strong pictorial warnings have brought substantial health care gains. However, illicit trade undermines tobacco control policy efforts and facilitates increased uptake of tobacco by youth and adults from low-income groups by making tobacco products more affordable and accessible, particularly to those from low-income groups. And because these products are not subject to legal restrictions and effective health regulations aimed at curbing tobacco use, such as pictorial warnings or banning sales to minors, this is fuelling the tobacco epidemic.

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In the South-East Asia Region, many countries have porous borders that provide easy opportunity for the smuggling of tobacco products. All South-East Asian countries have enacted stringent laws to control tobacco consumption – both on pricing and sale of tobacco products in-country as well as against import of foreign brands – and despite these efforts, there is still a thriving trade in smuggled tobacco products. In a bid to respond to growing illegal trade in tobacco products and to make a consolidated effort to put a break in this cycle of illegal transactions, The Protocol to Eliminate Illicit Trade in Tobacco products was developed. This international treaty was negotiated by the Parties to the WHO Framework Convention on Tobacco Control (FCTC), and was adopted by them in November 2012. WHO urges all Member States to speed up their process of ratifying or acceding to the Protocol. Ratification of the Protocol is necessary to respond to the financial, legal and health impacts of illicit trade in tobacco products.


VOICE OF health care

E R A C H T L A E H VOICE OF POLICY THINK TANK

We raise your voice to the concern authority & government

Dr. Gridhar Gyani In US we have pay for performance concept by some insurance companies. It will be too early for us. To begin with let us collect few performance indicators from public and private like SSI, UTI, ALS etc. Let these be mandated by payers and by government for their hospitals. For these we would need to train doctors on clinical audit and nurses for ICN. Things will bring better clinical outcomes. Manish Rastogi Is there any well planned synchronization /coordination between public and private healthcare facilities? Do not think this would throw open lots of possibilities and lead to better sustainability of both public and private facilities.. and more affordability for patients . Pl evaulate current scenario and respond. Dr V.K. Khanna I think low cost health insurance may help in lot of ways..... Gyani - We should first think of basics. Let us have effective regulation under which all hospitals comply with minimum WHO patient safety norms. Today many of government hospitals do not have fire NOC. Second step is to have categorisation. Third is to have logical costing of procedures. Without these we will not be able to bring private and public hospitals on same page. Manish Rastogi Why healthcare Equipments are so costly? What is the pricing method? Often cited... If huge R&D cost is the reason, should there be line drawn between break-even and Premium (price). Healthcare is "common welfare subject across many geographical regions/Markets. Is it not the market myopia that high price act against high volumes.

Mohd. Ameel Actually there are no incentives to the Indian manufacturers hence buying foreign products and selling in India is a better business model than make in india. Manish- In absence of not much support, why can't buyers and sellers come together at common platform for common gains to take the process forward. How long this would continue... High cost does damage the prospect of healthy bottom line for buyers and low sales does the same to sellers. This problem needs collective attention. Icing on the cake is even aftersales aspect is also a drain on finances. High time to wake up Mohd. Ameel Duties on spares and raw material is high compared to a finished product. Why would a buyer go for an expensive indian made product. Rajiv Nath Indian consumers willingly pay nearly double prices at times for foreign popular trusted brands but once they make up mind to buy an indian brand they will make them compete to unremunerative levels so u hv an increasing class divide Indian manufacturers when they find consumers unwilling to support them for higher prices for better quality start a never ending price war n hv no surplus to invest in marketing brand building advertising and this makes it worse after a while So R& D stops n frugal begins Result shoddy products Micky Govt need to step in to help manufacture develope the kind of quality available in foreign..in form of subsidy in automated machines, less taxes, ease of exports... It will result in more production nd less production cost..

Please evaluate the merits and demerits of this forum. Does this forum offer learning experience or not. What you need to change or suggest about this forum.VoH is positioned as vocal platform on healthcare issues and has a long way to go...Please help VoH to be more objective and effective in its mission. Please offer your feedback, even a “one liner� would be quite insightful info@medgatetoday.com w w w.medegatetoday.com July-August 2015

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MARKET WATCH

Medical Nonwoven Disposables Market in Asia-Pacific to Reach $3.3Billion by 2020 - Projects

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ccording to a new report published by apacmarket.com, titled, "Medical Nonwoven Disposables Asia-Pacific Market Research Report, 2014 - 2020", the Asia-Pacific medical nonwoven disposables market is expected to grow at a CAGR of 12.1% from 2015 to 2020. In 2014, surgical nonwovens segment accounted for about half of the Asia-Pacific medical nonwoven disposables market,largely due to the growing awareness for prevention of hospital acquired infections (HAI) and rising demand for sophisticated medical services. Asia-Pacific constitutes one of the most lucrative markets for medical nonwoven disposables. Largegeriatric population, growing demand for advanced healthcare facilities and rising health and

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hygiene awareness among patients is boosting growth of the Asia-Pacific medical nonwoven disposables market. Medical nonwoven disposables are gaining popularity over woven products due to improved comfort, resistance to infections and economical nature. However, growing number of minimally invasive surgeries with lower requirement of surgical products and environmental issues related to disposal of nonwoven disposable products are primarily restraining the growth of the market. In Asia-Pacific, surgical nonwoven disposable would be the leading revenue generating segment over incontinence nonwoven disposable. This is due the frequent usage of surgical nonwoven disposable in epidemic and pandemic outbreaks and mandatory application of surgical nonwoven disposablesduring surgical procedures.


MARKET WATCH

Key findings of the study: •

The incontinence nonwovens segment would be the fastest growing segment in the AsiaPacific market, primarily due to the increasing disposable income, rising prevalence of incontinence and increasing uptake of incontinence products

China was the leading contributor in the AsiaPacific medical nonwoven disposable market, with around 1/3rd share in 2014

Disposable diapers segment is expected to garner about 50% shareof Asia-Pacific Incontinence Nonwoven Disposables Market in 2020, due to the established market base and continued demand

Disposable underwear segment would be the fastest growing segment within Asia-Pacific Incontinence Nonwoven Disposables Market at a CAGR of 14.9% over the forecast period

China and Japan are the leading producer and consumer of medical nonwoven disposables accounting for about a third of the Asia-Pacific market revenue in 2014. Singapore, Thailand and India exhibits significant growth rate, owing to increasing trend of medical tourism activities and improving regulations towards health and hygiene. Leading companiesare focusing on merger and acquisition, and product launch as their key development strategies in order to strengthen market share across Asia-Pacific region. Key players profiled in the report includes, Kimberly-Clark Corporation, Polymer Group Inc., Medtronic Inc., Molnlycke Health Care AB, First Quality EnterprisesInc., SvenskaCellulosaAktiebolaget, Ahlstrom, Domtar Corporation UniCharm Corporation, and Freudenberg Nonwovens.

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NEWS Update

Study Suggest Stem Cell Therapy improves Quality of Life in Multiple Sclerosis Patients Multiple sclerosis (MS) is a debilitating, progressive neurodegenerative disease that typically only gets worse, but for many patients undertaking treatment at Dr Geeta Shroff’s Hospital, Nutech Mediworld, their symptoms have improved instead of progressing.

Amy Covey, a 30 year old woman from USA who was mainly wheelchair bound came to the hospital complaining of generalized weakness and low level of stamina. Further she had limited hand movement and occasional pain in the joints. Conventional treatment did not offer any options and she decided to undergo human embryonic stem cell therapy. A study that was conducted on 12 MS patients using human She showed improvement in all areas and is now able to walk embryonic stem cell (hESC) over two and half years has without any support, she is glad that she took the decision to shown that all the patients suffering from irritability and vision come to India. impairment showed improvement in mood and vision post stem cell therapy. Almost 91.6% of patients had difficulty in "A lot of people have lost hope on conventional medicine as walking with 45.45% showing improvement. 83.3% suffered they do not offer any cure for MS. At best, drugs may be used from excessive fatigue. This reduced in all the patients with to control the symptoms," Dr Shroff said. 40% becoming normal. The study of human embryonic stem cells is promising but "The first time I walked into this building I had to use the stick, no hospital specializes in such treatment. Nutech Mediworld couldn't even walk, so this is a big day for me! Within three is the only centre in the world offering hESC. Located in the months of stem cell therapy treatment, I have regained lower heart of New Delhi, it attracts hundreds of patients suffering limbs and upper limbs strength and can now walk without from many incurable diseases from across the world such as support. My concentration, attention and cognitive skills have UK, USA and Europe. significantly improved. Bladder function is normal," said 42 Embryonic stem cells are conventionally derived from year Gautam Sinha. the inner cell mass of the blastocyst. They are cultured Gautam was diagnosed with MS when he was just 24 at AIIMS. in the laboratory and have been shown to regenerate He suffered frequent sudden falls, had unstable movement, tissue. Recently, USA approved a few FDA approved clinical weakness in both lower and upper limbs, poor concentration, trials. lethargy, impaired cognitive skills and impaired bladder Dr Shroff established cell lines from a single, spare throwaway control. After trying conventional drugs, he had given up hope fertilized egg taken during a natural IVF cycle in the year as he did not see positive results. 2000. After extensive safety and efficacy evaluations, she Luckily, he was one of the 33 MS patients to receive treatment has developed a therapy for today’s incurable/ terminal at Nutech Mediworld using human embryonic stem cell conditions. (hESC) which are transplanted via various routes including MS is an auto-immune disease in which the body attacks injectables. His treatment was conducted in phases with initial its own cells and tissues. It is often diagnosed during prime treatment of 8 weeks and follow up treatment of 4 weeks. working years and is one of the most common causes of “The treatment may continue long but the best part is that disability amongst young adults. A ‘hidden disease’, the patient’s condition has significantly improved after the stem extent of its impact is not visible to others. The disease mostly cell treatment,” said Dr Shroff. strikes youth at a time when they are starting new careers, relationships or making plans for the future. In many cases, "I never ever hoped to get better, but my quality of life is just patients have to leave their jobs and restrict their movements. so much better," said Mr Sinha. Patients face a lifelong stigma of people seeing them as sick, Dr Shroff said stem cell therapy has also helped patients disabled and a burden to the society. with other neurodegenerative disorders like Alzheimers and Parkinson's. 26

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NEWS Update

India’s Youngest Kidney Transplant at Asian Institute of Medical Sciences

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eflecting its commitment to saving and enriching lives beyond boundaries, the team of Nephro and Kidney transplant experts at Asian Institute of Medical Sciences performed India’s first youngest Kidney transplant on a three year old boy Muslim Ahmed from Iraq. Team Led by Dr. Vijay Laxmi, Transplant Surgeon, Dr. Jitendra Kumar, Director Kidney Transplant, Dr. Vipin Gupta, Urologist and Dr. Divesh Arora and entire Anaesthesia team not just gave him a new lease of life, but also showing a ray of hope to many more children suffering from end stage Kidney disease. Child Muslim Ahmad was on Haemodylysis in Iraq before he was admitted in Asian Hospital in the month of Jan 2015 with sudden Kidney failure, he was kept on kidney dialysis for 4 months According to Dr. Vijay Laxmi, Transplant Surgeon at Asian Institute of Medical Sciences said “Child Muslim Ahmad of Iraq was found to have kidney failure at a young age of 3 years, normally such children are put on peritoneal dialysis till they grow in size to receive a kidney transplant .But peritoneal dialysis is not available in Iraq and due to very small size the child was not able to tolerate the other alternative "Haemodylysis "When this child was admitted in Asian Hospital, the biggest challenge in this case was to provide a sort of permanent solution. As the child was very small, usually kidney transplant in

such small children is very challenging and avoided. Due to narrow size of the blood vessels anastomoses of new kidney is very difficult. Such kidneys are prone to get clotted. Stress of surgery is also challenging for a small kid with kidney failure. However, due to non availability of any suitable treatment at Iraq the choice was actually between death and transplant. Our team at Asian hospital accepted this challenge and transplanted his grandfather's kidney in this child on 22nd May 2015.” Director Nephrology and Kidney Transplant Dept. Dr. Jitendra Kumar Said “As expected the post operative course was very turbulent with child developing stress cardiomyopathy requiring prolonged ventilatory support. Now child has successfully completed more than a month of transplant, & he is the youngest transplant recipient in India. His recovery and grateful eyes of his family is the greatest reward for the team at Asian hospital which comes up with another milestone in the healthcare.” Padamshri Dr. N K. Pandey, Chairman & Managing Director, Asian Institute of Medical Sciences Said “We often treat international patients but in this case due to the age of the patient doctors were afraid to operate and patient was in hospital for 6 months but now we are happy that child is fine and ready to move back to his country”.

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NEWS Update

New drug brings hope for children with leukaemia Australian scientists have said they have discovered a new drug that holds great promise for treating children with an aggressive form of leukaemia.

Manesh, based at the Children's Cancer Institute, have shown that a drug known as PR-1042 is effective against laboratory models of aggressive T-ALL. Their findings have been published in the prestigious journal Blood. The research team tested PR-104 through the Pediatric Preclinical Testing Program, a consortium funded by the US National Cancer Institute (NCI), to prioritise and fast track new drugs into clinical trials in children with aggressive cancers. "During the 10 years we've been funded under the NCI program, we've tested over 70 drugs and combinations, and PR-104 is one of the most exciting yet, with the potential to be fast-tracked into clinical trials for children," said Lock.

"We were so encouraged by our first results with PR-104 that we undertook additional studies which showed the Australian scientists have said they have discovered a drug to be preferentially active against T-ALL, a subtype new drug that holds great promise for treating children of ALL affecting white blood cells known as 'T cells'. with an aggressive form of leukaemia. "We believe that PR-104 might be an effective drug for A Study was undertaken at University of New South patients who have initially benefited from conventional Wales (UNSW) where 70 different drugs were tested over treatment for T-ALL, but who have subsequently 10 years . relapsed." Around 150 Australian children are said to be diagnosed with acute lymphoblastic leukaemia (ALL), the most common childhood cancer and 15 per cent would have an aggressive subtype of 'ALL' known as 'T-ALL', that is generally less responsive to therapy and more likely to relapse.

At first baffled by why T-ALL responded to PR-104, the researchers realised that only the T cell subtype expressed high levels of AKR1C3, an enzyme that activates PR-104.

The research team is in the process of examining the molecular biology behind AKR1C3, and trying to understand why T-ALL cells express very high levels of UNSW Conjoint Richard Lock and Donya Moradi the enzyme. NC NSA

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NEWS Update

Benign Prostatic Hyperplasia Causes, Symptoms and Treatment Benign Prostatic Hyperplasia (BPH) is a natural condition which develops in all men from the age of 40. BPH refers to benign prostatic hyperplasia (increase in size of the gland). BPH is a benign (non-cancerous) enlargement or growth of the prostate gland. As the prostate surrounds the top part of the urethra, enlargement of the prostate makes the urethra narrower and puts pressure on the base of the bladder. Narrowing of the urethra can affect the passing of urine in a number of ways. BPH symptoms (referred to as LUTS - Lower urinary Tract Symptoms) can have a major effect on quality of life. Symptoms are usually not dependent on size of the gland alone but on variety of factors. Causes Benign Prostatic Hyperplasia (BPH) is part of the process of men growing old. Genetics may also play a role, this is especially true for severe BPH requiring surgery in men younger than 60. Aging and the male sex hormone testosterone are linked with BPH. It is known that BPH only happens when testosterone, the male sexual hormone, is present.

An enlarged prostate can result from a prostate infection or from prostate cancer, although those occur less frequently and are not as inevitable as BPH. Untreated enlarged prostate can lead to urinary tract infections, kidney or bladder stones, or urinary retention and kidney damage. When the bladder is repeatedly filled to the point of near bursting due to holding in the urine, it damages the lining of the bladder. This makes the bladder more susceptible to infections, as well as to stone formation. As the prostate enlarges, the passage of urine is inhibited, which in turn inhibits the complete emptying of the bladder. This, if untreated, can lead to back pressure changes and enlargement of the kidneys leading to kidney failure. Treatment

Treatment of BPH is usually reserved for men with significant symptoms. Watchful waiting with medical monitoring once a year is appropriate for most men with BPH. Surgery, transurethral surgery, laser and open surgery are required for treating complications of BPH. Absolute indications for surgery in BPH include recurrent retention of urine, recurrent infections, Symptoms hematuria, stone Many men with BPH have no symptoms. When formation and symptoms (known as Lower Urinary Tract Symptoms kidney failure or LUTS) occur, they may range from mild and barely due to retention. noticeable to serious and disruptive. The amount of T h e prostate enlargement is not always related to the severity complications of the symptoms. Some men with only slight enlargement of BPH can have serious symptoms. And some men with a great deal be treated if of enlargement have few symptoms. BPH causes urinary detected at an early stage; problems such as: hence efforts • Trouble getting a urine stream started and completely should be stopped (dribbling) made to create awareness • An urge to urinate again soon after urinating. This amongst medical feeling may even wake you up at night professionals as well as public • A weak urine stream to identify early • A sense that your bladder is not completely empty after symptoms of the disease. you urinate •

Pain during urination (dysuria)

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Update SPEAK

Kick the bud for better tomorrow! ‘Smoking is Injurious to Health’, this warning probably we have heard or seen umpteen number of times in TV commercials, movie theatres, print ads and at a few public places, but seldom anyone bothers to pay any heed to it.

Tobacco killing the next generation

DOCTOR

Smoking during pregnancy will have major effects on generation next:

• • We have been talking about banning smoking, law has • been enacted, but nothing has happened till date, on the • contrary smoking has gone up and ironically numbers of women smokers are on the rise. • According to the studies India now has 12.1 million • women smokers and falls only behind the United States in •

Likelihood of increased heart rate in new born High risk of miscarriage and stillbirth Premature delivery /or born with low birth weight Increases baby's risk of developing respiratory (lung) issues Children born with asthma Greater chance of child birth with abnormalities Increases risk of Sudden Infant Death Syndrome

this segment. While an average male smokes 6.1 cigarettes By 2020, there will be 1.5 million deaths from a day, the same rate for an average woman is 7. smoking in India and we have seen an increase in fertility With the increase in number of women taking up problems and cancer-related issues among women over smoking, we are risking the next generation; our next the past few years, something that can be attributed to generation will be born with number of abnormalities, if we increase in smoking among the females. The nicotine (the do not stop at this stage. Already, there have been serious addictive substance in cigarettes), carbon monoxide, and issues with regards to fertility of women, problem with numerous other poisons you inhale from a cigarette are conceiving, miscarriage, still birth and the worst, children carried through your bloodstream and go directly to your baby, Smoking affects new born when there is a shortage of being born with Asthma. oxygen which has devastating effects on baby's growth and Cigarette smoke contains over 4,000 harmful chemicals development. Babies weight, size, body, lungs, heart, brain such as carbon monoxide, nicotine and cyanide. Tobacco function all gets effected. causes long-term damage to the lungs, brain and blood of an unborn child and can cause pregnancy emergencies in There are no official records to tell us how many the mothers by reducing the amount of essential oxygen females are affected by smoking every year, but the and nutrients, an unborn baby needs for healthy physical number is expected to be very high. After all, tobacco kills every third user “prematurely through cancer, heart and and mental development. lung diseases” and 2,500 people die daily owing to tobacco A woman who smokes during pregnancy is at increased consumption in India. Women who smoke are gradually risk of a wide range of problems including ectopic forming a large chunk of that ratio. pregnancy, miscarriage and premature labour. Women Nicotine addiction is very hard to do away with. Parents who smoke are twice as likely to give birth to a low birth who smoke are more likely to have children who smoke; so weight baby compared to non-smokers. Low birth weight if you stay tobacco-free your child stands a better chance of babies are at greater risk of death, and are more vulnerable never getting the habit of tobacco. to infections, other health problems such as breathing Dr. Samir D. Garde difficulties and long-term health problems in adulthood. Pulmonologist, Global Hospitals, Mumbai

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NEWS Update

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DOCTOR Update SPEAK

Computer Navigation Technology: Changing the Face of Knee Replacement Surgery Till two decades back, a knee replacement was considered a difficult procedure with longer recovery time, and inadequate recovery outcomes. In recent years, however, better techniques and advanced methods have radically improved outcomes, made the procedure more patientfriendly and longer lasting; resultantly much more common. Every year, thousands of patients in India undergo knee or hip replacements and get a new lease of life. The beneficiaries are not just septuagenarians but also relatively younger patients in their 50s who chose to undergo the procedure to prolong their active and productive lifespan. In some cases much younger patients may need the procedure due to injury, early onset arthritis or congenital bone deformity. Improved quality of artificial implants, different implants to meet the requirements of different anatomical structures like men, women and ethnicity; as well as better surgical methods have contributed to improving the outcomes and durability of total knee replacement. A major leap that has taken place in the field of joint replacements is computer assisted or image guided surgery. It is a technique where surgery is performed with the aid of computerized images. Using computer navigation to align the joint, better alignment of the artificial joint is achieved and chances of human error are ruled out. At Indian Spinal Injuries Center we use

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the computer navigation system during the operation to ensure that your knee is aligned properly. This permits the surgeon to monitor every step of the surgery and allows error to be identified and corrected. Accurate alignment of the knee components is critical to the overall function of your new joint. A well-aligned knee replacement is more likely to last longer. We have a team which is exclusively trained in using the computer navigation for joint replacements. Computer navigation helps in precision bone cutting with 100% results. Moreover, there would be no loss of blood with the other benefits of early recovery, quicker discharge from the hospital and better knee function. Though this technology is yet to become a common practice in India, we find in it tremendous promise in ensuring greater accuracy in positioning the new knee joint. Why Knee Replacement? A knee functions as a joint between the upper leg bone and the lower leg bones. The bones, the joints and their edges are covered by cartilage that keeps the movement smooth and prevents friction between the edges. With years of wear and tear, the surfaces where these bones meet can become worn out. The reasons may include age related wear and tear, severe knee osteoarthritis, inflammatory arthritis, rheumatoid arthritis, and other general arthritic conditions. This makes movement extremely painful and effectively bars you from leading a normal life. Climbing


DOCTOR SPEAK

stairs becomes a problem, walking long distances becomes difficult and even bending is not possible. In such cases the aim of knee replacement is to make life easier, relieve pain, improve quality of life and enable the patient to perform normal day to day functions with ease. Surgeons replace more than a million hips and knees each year in the U.S. Studies show joint replacements can significantly relieve pain and increase mobility in about 90% of people who get them. Why computer-assisted technology? There are several potential benefits for those who have computer-assisted surgery with their total joint replacement, including increase in the life of your replacement, reduction in the risk of revision surgery, greater stability and range of motion, and improvement in the overall function of your joint replacement. Recent Studies Results showed that patients who had undergone TKA with use of computer navigation had a significant When to consider knee replacement for osteoarthritis? reduction in the rate of revision due to loosening which,  Pain and stiffness. Severe knee pain that limits your according to the researchers, is the most common reason everyday activities. Pain that makes it difficult to walk, for revision of TKA. Computer-assisted surgery may climb stairs, get up from a chair, or carry on with other allow for less-invasive surgical techniques, which means normal activities. Knee pain while resting, day or less cutting and bleeding and several other potential night, inability to bend and straighten your knee. advantages.  Chronic knee inflammation and swelling that does not improve with rest or medications. Computer assisted joint replacement have been practiced in India for past 20 years but there is glaring lack of  Poor quality of life. It's not only pain itself that matters, trained doctors in North India. Very few hospitals have but how the pain affects your daily life. Do your joint specialized or trained doctors in computer navigation. problems limit what you can do? Do they affect your mood? Advantages of Computer navigation technology  Bone damage. X-rays and other imaging may show  Provides your surgeon with comprehensive data severe joint damage from osteoarthritis or other about your knee anatomy which may help determine conditions. proper placement of your joint replacement  Non-surgical treatment failure. Medication,  Ability to plan for surgery with a computer generated injections, devices-- like walkers -- and other treatments model of your knee are not helping enough.  Provides the surgeon with feedback and the ability  Deformity. Your knee is severely swollen or your leg to correct potential malalignment during the surgery is bowed.  Allows for better visualization of anatomy, which A total knee replacement is only carried out after other is particularly important when minimally-invasive treatments have been tried. It involves completely removing the joint damaged by osteoarthritis and replacing it with a techniques are used.  Reduces blood loss during surgery, which lessens new joint. The operation can be carried out under a general the need for a blood transfusion, and ensures faster or a spinal operation. The anesthetist will discuss your options with you before your operation. recovery  Reduces length of your hospital stay. One can get rid At Indian Spinal Injury Center (ISIC), our Orthopedic Department has a multidisciplinary approach to care, with of stick within 4-5 weeks.  Less scarring and shorter post-operative physical our consultants, nurses, physiotherapists and occupational therapists all working together for one purpose – the benefit rehabilitation of our patients following total knee replacement.  Computer navigation increases longevity of the joint Article by Dr Vivek Mahajan and decreases the chances of revisions surgery. Joint replacement and arthroscopy surgeon, Indian Spinal Injuries Centre w w w.medegatetoday.com July-August 2015

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DOCTOR Update SPEAK

World Hypertension Day World Hypertension Day is celebrated every year on 17 of May to raise the public awareness about hypertension, its preventive measures and dangers if not managed. It was first celebrated on 14 of May in the year 2005 organized by the World Hypertension League (WHL).

It is also an inheritable disease which can be inherited to children from parents having hypertension or family history of diabetes, obesity, smoking, lack of exercise, excess alcohol drink, use of oral contraceptive pills and etc. Its complications are coronary artery disease (CAD) due to narrowing of arteries, brain haemorrhage due World Hypertension Day 2015 to blood leak in brain (stroke), heart attack, aneurysm, World Hypertension Day 2015 would be celebrated by kidney failure, heart failure, eye damage and etc. the people all thought the world on 17 of May, on Sunday. It is easy to get prevented from the primary hypertension however secondary hypertension is severe condition World Hypertension Day History which can be managed and treated if managed well. Celebrating World Hypertension Day all over the world It needs to change lifestyle and follow healthy living was established and started by The World Hypertension habits (avoid smoking and alcohol, low sodium intake League (World Hypertension League). World Health of 1.5 to 2.5 g, low-fat and high-fiber diet, fruits and League is a health organization lead around 85 national green vegetables, proper physical exercise, aerobics, hypertension societies and associations worldwide. It healthy weight, regular pulse and Blood Pressure check, had started the campaign of hypertension day to increase reduce stress, low bad cholesterol level, healthy family the common public awareness about the hypertension. It atmosphere etc) to treat the condition well. aimed to fill the gap of the lack of appropriate knowledge among people about the hypertension and people Why World Hypertension Day is Celebrated suffering of it. World Hypertension League had launched World Hypertension Day is celebrated annually since the campaign of World Hypertension Day first time on 2005 to disseminate the message of maintenance of 14 of May in 2005 however it was started the celebrating normal blood pressure among common public. High dedicatedly every year on 17th of May since 2006. Blood Pressure, e.g hypertension causes various complications in the body and may lead to the major What is Hypertension risk to the heart, brain, kidney, eye even coma or death. Hypertension is a condition called high blood pressure Blood pressure can be measured at home or hospital during which the arterial blood pressure raises to high using acceptable measuring device called BP apparatus. level from the normal level (120/80 mmHg). It is medical (Sphygmomanometer) condition called as silent killer as it does not show any clear symptoms however severe hypertension shows According to the statistics, it is noted that around 3 out some symptoms of headaches, sleeplessness, palpitations, of ten people are suffering from hypertension worldwide. blurred vision, fatigue, dizziness, confusion, ringing sensation in the ears, breathing difficulty, irregular heartbeat which may even lead to even coma. It is divided in two types (primary or essential hypertension and secondary hypertension) on the basis of its causative factors. The primary hypertension is more common type (about 95%) however its causes are unknown. Whereas, causes of secondary hypertension are kidney damage, adrenal gland over-activity, sleep apnoea syndrome, tumours, recreational drugs, thyroid gland dysfunction, aortic co-arctation, pregnancy-related conditions, over or wrong medications, alcoholic drinks bad food and etc. Dr. M. Wali 34

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DOCTOR NEWS Update SPEAK

Approximately 1.8 billion of the people globally are suffering from hypertension and the most surprising thing is 50% of them are totally unaware of their condition and some of them who are aware of their condition do not take any medical action for their blood pressure. Some of the objectives of celebrating this campaign on annual and colleges, messages distribution through the TV and basis are mentioned below: radio Channels and lots of other activities. • To motivate the common public for regular check-up Meetings of the medical professional’s experts and of their blood pressure at least once a year. advisers are held for highlighting the common problems

• To encourage the people having hypertension on of hypertension on national and international level, global basis to go to their health practitioner for discussing the new and most easy preventive and control measures for the people with hypertension. regular check-up and proper treatment. • . To promote all the common public especially youths and young people to maintain their normal weight, normal cholesterol level, normal blood pressure, healthy living, healthy eating, regular physical exercise and etc. • To encourage people to leave their bad habits like drinking alcohol, lazy routine, oily and fatty diet, fried and spicy diet, junk food, smoking, and to reduce weight.

World Hypertension Day Theme World Hypertension Day is celebrated every year using a particular theme of the year selected by the World Hypertension League to make the campaign more effective on international level. It has been recommended by the World Hypertension League that Blood Pressure should be less than 140/90 mmHg for general population and hypertensive population without complications whereas for people with diabetes mellitus or chronic kidney disease, it should be less than 130180 mmHg. Some of the past year wise themes are mentioned below:

• To motivate the people for regular check-up of their health and blood pressure by providing them an environment through free blood pressure check-up • The theme for 2005 was "Awareness of high blood pressure". camp. • To spread awareness to common public about the • The theme for 2006 was "Treat to goal" focusing to keep blood pressure under control. blood pressure, high blood pressure, its complications and how to maintain normal blood pressure, weight • The theme for 2007 was "Healthy diet, healthy blood and healthy life style. pressure".

How World Hypertension Day is Celebrated

• The theme for 2008 was "Measure your blood pressure ... at home".

World Hypertension Day is dedicatedly celebrated every year on 17th of May since 2006 to raise the common • The theme for 2009 was "Salt and High Blood Pressure: Two Silent Killers". public awareness about the hypertension through the variety of activities and events. Health professionals and • The theme for 2010 was "Healthy Weight - Healthy medical professionals from the government and nonBlood Pressure". government organizations participate in the campaign • The theme for 2011 was "Know Your Numbers and celebration and support in organizing lots of events for Target Your Blood Pressure". easy understanding of the public, spreading awareness. • The theme for 2012 was "Healthy Lifestyle-Healthy Some of the activities which are getting organized on Blood Pressure", annual celebration of the campaign are public forum, debates on the Subjects of high blood pressure, brisk walk • The theme for 2013 was "Healthy Heart BeatHealthy Blood Pressure", or run activities, health screening, free blood pressure check-ups camps, media write-up, banners and poster • The theme for 2014 was "Know Your Blood distribution in the schools, colleges and other educational Pressure". institutions, discussions, quiz competitions in the schools • The theme for 2015 is "Know Your Blood Pressure". w w w.medegatetoday.com July-August 2015

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DOCTOR NEWS Update SPEAK

Walking up to Social Networks A disturbed sleep cycle due to smart phones and instant by an average of 10 to 16 years. It’s so important to be messaging can lead to undue stress. A lot of us are sleep physically active your whole life, not just in your 20s to deprived. All of this contributes to hypertension. 40s. The benefits of comprehensive lifestyle modification, including the DASH diet and increased exercise are much Measuring at Home more than managing a single life style intervention' Yoga Go to the doctor to get your BP checked rather than doing is one such thing that can make great difference in the it at home. If you take your BP five times from your home control of Hypertension. Patient education has been demonstrated to result in improved blood pressure. machine, the five readings would vary. Make the right lifestyle choice

Diet

The DASH (Dietary Approaches to Stop Hypertension) dietary pattern which is high in vegetables, fruits, lowfat dairy products, whole grains, poultry, fish, and nuts; and low in sweets, sugar-sweetened beverages, and red meats. It is consequently rich in potassium, magnesium, calcium, protein, and fiber, but low in saturated fat, total fat, and cholesterol. DASH diet can reduce the systolic Mind the weather blood pressure by 8-14 mm Hg. Combining the DASH When the weather changes, your dose of medicine to dietary pattern with modest sodium restriction produced regulate your blood pressure should change too. BP rises an additive antihypertensive effect. in the cold, so in winter, visit your doctor to regulate your Exercise prescription. Aerobic exercise, and possibly resistance training, can Be happy at work decrease systolic and diastolic pressure by, on average, Keep busy, always enjoy your work and do some 4 to 6 mmHg and 3 mmHg, respectively, independent of homework before getting hassled about meeting weight loss. (3 to 4 sessions of moderate-intensity aerobic deadlines. Simplicity costs nothing, be patient before you exercise lasting approximately 40 minutes for a period of 12 weeks.) climb the stairs of life. Spending long hours at work, a secondary lifestyle and junk food shoots up your BP. So, work out, cut down on starchy food and extra salt and have balanced, nutritious diet, Get your BP checked once in a year if you are healthy, once in six months if you have health concerns and every month if you have diabetes and hypertension.

On the waterfront

Alcohol

Swimming is the best stress buster. People who are Women who consume two or more alcoholic beverages addicted to swimming are usually fit, healthy and don’t per day and men who have three or more drinks per day have a significantly increased incidence of hypertension rely on medication. compared with nondrinkers. This effect is dose related Catch it young and is most prominent when intake exceeds five drinks If parents are hypertensive, then children are more at risk. per day. Decreasing alcohol intake in individuals who Encourage them to take on exercise yoga and eat healthy. drink excessively significantly lowers blood pressure. Moderate alcohol use (one drink per day for women and Lifestyle modification one to two drinks per day for men) has a limited effect on blood pressure, associated with a modest decrease Exercise is most potent drug and by far the cheapest and in cardiovascular risk as compared with no alcohol best thing you can do. Exercise can delay the disability consumption.

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PRODUCT Update LINE

Hematopoietic Progenitor Cells (HPC) Novel parameter in Hematology Analyzer Peripheral blood stem cells (PBSC) are increasingly used to restore hematopoiesis as an alternative to bone marrow transplantation. It is important to determine the precise time for HSCs (hematopoietic stem cells) to be collected for a reliable, rapid and successful hematological recovery.

Analyzers. Infact the newly launched Sysmex XN series is equipped with a White Precursor Cell (WPC) channel to differentiate abnormal lymphocytes and blasts by using the optical detection system and Fluoroscence flowcytometry.

A study (published in December, 2013, in the International Journal of Laboratory Hematology) conducted by the scientists at the National Cancer Center Hospital (Tokyo, Japan) concluded that the HPC count obtained on a Sysmex XN analyzer correlates accurately with the enumerated CD34 cells. Cells expressing the CD34+ and hematopoietic progenitor cells (HPCs) were compared in 76 granulocyte colony-stimulating factor (G-CSF) mobilized blood or apheresis samples taken from 18 healthy donors and 6 Flow cytometric enumeration of CD34+is the standard method patients undergoing autologous PBSCT. CD34+ cells of counting. The International Society of Hematotherapyand were isolated using MACS magnetic cell separation kits Graft Engineering (ISHAGE) gating strategy isused for (MiltenyiBiotec – BergischGladbach, Germany). CD34+ cell detection. An alternate method for quantification The investigators found a strong correlation between the of circulating HSC minimizes the number of CD34 numbers of HPCs and CD34+ cells. The expected total determination, thus saving important resources. Since the number of HPCs in the final product was estimated from introduction of the HPC software in 1997 in the high end HPCs in pre apheresis peripheral blood (PB) or mid Sysmex analyers, many studies of HPC determination versus apheresis product. This count was found to correlate well CD34+ cell enumeration have been performed. The HPC with the total number of CD34+ cells in the final products. parameter serves as an inexpensive and fast alternative for Moreover, the change in HPCs in PB closely resembled that of CD34+ cells during mobilization. Further, studies using quantification of the circulating HSC Cells. Sysmex Corporation, Japan offers the latest and best immunomagnetic beads suggested that majority of CD34+ technology in hematology analyzers. Marketed in India, cells existed in HPCs, and vice versa. HPC and HSC express high levels of the cell surface glycoprotein,adhesion receptor CD34. The levels of CD34 expression decreases with cell maturation and differentiation. Expression of CD34+ is thus a defininghallmark for hematopoietic stem cells (HSCs) andprogenitor cells (HPCs) in bone marrow (BM),peripheral blood (PB) and cord blood. An accurate quantification of circulating CD34+ stem cells is important to decide the optimal time for collection.

exclusively by Transasia Bio-Medicals Ltd., Sysmex offers a Conclusion whole range of systems ranging from 3 to 6 Part Differential • The Sysmex XN analyzer can carry out an HPC enumeration without the use of monoclonal antibodies

Kanchan Jeswani

Product Manager Hematology Transasia Bio-Medicals Ltd.

Sensitivity of flagging of blasts is enhanced in the WPC channel of the instrument. It gives a clear demarcation between the blasts and the abnormal lymphocytes.

The total number of HPCs in the final products, as well as from pre apheresis PB and intermediate products during apheresis, can be used to predict the final amount of collected CD34+ cells.

The detection and number of HPC in the peripheral blood could possibly provide a standard and rapid alternative for predicting the yield of stem cells collected by apheresis.

HPCs may also be a good indicator to know the optimal timing for collection of the peripheral blood stem cells.

The HPC count can thus be a useful potential parameter in optimizing timing for CD34+ enumeration prior to leukapheresis. w w w.medegatetoday.com July-August 2015

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EXPERT VIEWS

From Medical to Lifestyle Products: The Evolution of Spectacles Has Been Revolutionary Are you a technology addict who spends most hours of his waking time in front of digital screens, or an active outdoor enthusiast, a busy mom whose rough lifestyle needs strong spectacles, a senior citizen or a student? No matter what your job profile is or what kind of lifestyle you lead, today your vision correction needs can be customized for you.

Spectacles for working professionals

The digital revolution of the 1990s has not only accelerated the pace of our lives and changed the communications paradigm, it also radically shifted the way we work and live. Ten years back, mobile phones were just meant for talking, the concept of Smartphone was yet to catch up; laptops were not a common accessory and most of us The much-in-demand spectacles have evolved searched for cyber cafes to send mails. tremendously over the past few decades to graduate from just being vision correction devices to lifestyle As per findings of American Optometric Association products and now even prevent harm to the eye. There (AOA), more than 70% of ~143 million Americans is no one-fits-all approach to spectacles today. Not only complain of the computer eyestrain due to their daily have spectacle lenses evolved into better looking, far work. While we do not have such a consolidated figures from once geeky eye accessories, they have also evolved for India, clinical evidence does suggest an increasing in terms of usage and need. In fact, people today shop number of people suffering from visual fatigue. Today life for spectacles that suit not just their eye correction revolves around digital devices tablets, smart phones, needs but also their personality and some go further and LED screens – these devices emit UV and blue light - this light causes a lot of stress and fatigue to our eyes. If you choose spectacle lenses that prevent eye disease. calculate your daily activities, you would be surprised In developed countries, the percentage of spectacle- to find how much time your eyes spend gazing at digital wearers ranges from 30 to 50 per cent of the population. devices and therefore the fatigue and strain your eyes The availability of new lens designs, new technology and are subjected to. Essilor Even people who do not need innovation not only help people see better and appear correction or have power but spend a lot of time in front more attractive but also protect the eyes and prevent of the computer often experience eye fatigue symptoms eye diseases. New age lenses are thinner and can be such as red eyes, itching, burning, headaches. Essilor fitted in any type and size of designer frames, and can be has developed Crizal anti fatigue lenses to combat customized toyour individual requirement. digital eye strains. The optical design of these lenses result in increased visual comfort, less eye fatigue and a

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EXPERT VIEWS

more positive workday. Crizal Anti fatigue lenses help in Spectacles as fashion accessory removing the effort in focusing on screens. These glasses are designed to give you optimum comfort through the With spectacles becoming the most incredible accessory, the shape of the frame and color can truly date you to an day. era. Bringing back the era of 70s and 80s, the fashion of Spectacles as a style statement large frames is one of the latest trends. Be it for vision correction or establishing a style statement, different If 20 years back, people avoided wearing spectacles shapes and size of spectacles play a major role in because of the geeky look they inspired, today people carving the personality. The retro and vintage styles are readily opt for stylish and smart spectacle lenses. While the latest hot picks. Selecting a pair from the available they offered the precise visual correction needed, glass multi-colored laminates can also help in expressing your lenses were heavy, breakable and were not equipped creative side. to provide additional benefits such as protection from UV radiation. For people with high prescriptions, glass Spectacles for Outdoor Enthusiasts lenses also had the effect of magnifying the eye, giving what is often referred to as the ‘coke-bottle’ look. The Often, the spectacle lenses that serve you very well new age polycarbonate material lenses have made such indoors may not be of utmost use when you are inconvenience and aesthetic concerns a thing of the past. engaged in high impact outdoor activities. Spectacles for outdoor should be capable of protecting your eyes For professionals who wish to avoid full frames, rimless from the harmful effects of UV, , providing protection and three-piece mountings are readily available against glare of sun or traffic lights, providing you an alternatives. More than ever before people today use unmatched clear vision, giving you a true color along spectacles as a style statement to add character to with great eye comfort. This has given rise to a new range their personality. Apart from innovation in lenses, a lot of advanced lenses Essilor Optifog lenses – that protect of design and technical innovation has also been made your lenses from fogging, Xperio polarized lenses that to make frames more versatile and colorful. A number reducing reflections and protect you from glare and give of people today keep more than one spectacle to you true color perception. With over 400 designs and complement their different looks, much like people keep combinations of lenses to choose from, certainly there more than one pair of shoes. is no dearth of spectacles for outdoor activities with Xperio. Spectacles as Preventive Devices Newer discoveries in the field of ophthalmology have also propelled innovation in lens designs and construct. For example, the breakdown of light spectrum into its components and the analysis of the effect of each on the eyes is a recent phenomenon. The harmful effects of UV radiation on the eyes are well-known. Long-term exposure to UV radiation is linked to carcinomas as well as cataracts. Essilor in association with the Paris Vision Institute also deeply analyzed the effects of blue light. This light emitted by the sun, by artificial light sources such as LEDs and computers or smart phones, –is in the range of the visible light spectrum with wavelengths between 380-500 nm – some of this blue light plays a beneficial role in your health, in particular by regulating the internal biological clock that controls, sleep , hunger, moods. However, a specific band of this light might have a harmful effect on the eyes, this harmful blue lights will lead to retinal cell death. Crizal Prevencia, the revolutionary new age lens is the first lens to offer selective protection against harmful blue light and UV rays. It preserves your overall well being by letting essential visible light to pass through and provides optimal vision and durable transparency.

Mr P Ramachandran Group COO Essilor brands

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EXPERT VIEWS

SMART WOUND HEALING THROUGH ANDROID APP IIT Kharagpur amalgamates medical science with mobile technology. Untreated wounds are a major threat to the public health and countries economy as they have detrimental effect on patient’s quality of life leading to depression and social separation. Expensive treatment and unavailability of good healthcare facilities in remote location of rural India leads to procrastination and hence aggravates the problems. Healing process is further retarded infinitely due to inaccuracy in assessment of the wound by clinicians, nurses or dermatologists. In India approximately one in every two hundred person suffers a chronic wound infection taking the shape of a silent epidemic. Downsides of routine diagnostic techniques: Presently, the parameters considered for quantitative analysis of such lesions are shape, perimeter, surface, depth, biological nature of the skin tissues, wound severity stage, burn degree using routine diagnostic techniques such as ruler based methods, transparency tracing, alginate casts. These methods leave a significant room for human error and inaccuracy in analysis. Effective diagnosis and treatment of the wounds relies largely on a precise identification and measurement of the wounded tissue; however, in current clinical process, wound evaluation is based on subjective visual inspection and manual measurements which are often inaccurate. Poor circulation, often develop and enhances chronic wounds that are slow to heal and that require daily care. The wound healing rate is primarily quantified by the rate of change of the wound’s surface area. Inexpensive and Easy-to-use: Amalgamation of medical science with mobile technology presents a number of opportunities to bend the health care cost curve. In the span of two decades, ever-more sophisticated mobile technology has fundamentally been transforming the health care industry. Dr. Chandan Chakraborty (Associate Professor, Medical Science & Technology, IIT Kharagpur) and the mastermind behind 40

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this project says, ”Given the cost and inconvenience of regular visits to wound clinics and for providing real-time care to remote and rural areas, we have developed first known image analysis tool that can complement to services rendered by wound clinics. Specifically this work presents a smart phone app (Android), which tracks/ identifies the wound size and wound healing/management process based on images captured with a smart phone.” This new mobile-based system is designed for fast and accurate segmentation and identification of wounds, both from the standpoint of improving health outcomes in woundmanagement, and in making clinical practice more efficient and cost-effective. Satisfactory results of this real time mobile system suggest a promising tool to assist in the field of clinical wound 3 evaluation. The simplicity of the algorithm/framework used suggests that it is a valuable tool in clinical wound evaluation. For further information on the research please write to Dr Chandan Chakraborty (chandanc@ smst. iitkgp.ernet.in).


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EXPERT VIEWS

Kidney Transplant: Blood Group Matching no More a Barrier Kidney transplant is a life saving treatment for kidney failure patients and now it can be easily done with almost 100% success. But the major problem with kidney transplant is shortage of organ donors. This contributes to growing transplant waiting list. Newer advancement in transplant techniques and medicines allow to do transplant in patients without blood group matched donor (ABO incompatible transplant) to increase the donor pool. At present this is available only at few centers like PSRI.

Patient was admitted about 2 weeks before provisional transplant date and immunosuppressant drugs started. Plasmapheresis was done to remove preformed antibodies against donor blood group antigen on alternate day basis. Plasmapheresis is a procedure in which plasma containing antibodies removed from the blood by a cell separator. Intravenous albumin and normal saline were used as replacement fluid. Each plasmapheresis was followed by intravenous immunoglobulin. Patient was dialyzed on alternate day basis during hospital stay. We checked One of our patients, a 32 year old male presented to us routine blood parameters regularly. with advanced kidney disease and was put on urgent hemodialysis. Need for kidney transplant was explained After achieving minimum target antibody levels in the to patient but only blood group matched donor in the blood of recipient, kidney transplant was done. Patient family was his mother. She was investigated and found started passing good amount of urine post transplant and unfit because of medical reason. After explaining the there was fall in serum creatinine to normal level over cost and long term outcomes of ABOi transplant, patient’s next 3 days. Patient was discharged on post operative day wife (blood group A+) was accepted as a donor. Patient’s 8 with serum creatinine of 1.0 mg/dl. Now he is 6 months blood group was O+ positive. post transplant and going for his work everyday. OTHER FACILITIES FOR KIDNEY FAILURE PATIENTS AT PSRI HOSPITAL:

—DR. Sanjiv Saxena MBBS, MD (MED), DNB (NEPHROLOGY), SENIOR CONSULTANT & HEAD, Department of Nephrology, PSRI Hospital 42

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Laparoscopic donor nephrectomy

Donor swapping (when a living kidney donor is incompatible with the recipient, exchanges kidneys with another donor/recipient pair).

Kidney transplant in complex cases (marginal donors, difficult vascular anatomy)

Pediatric kidney transplant CRRT (slow continuous hemodialysis in hemodynamically unstable patients)


EXPERT VIEWS

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EXPERT VIEWS

The Monsoon And All That It Comes With Finally some respite from the heat. It's time for the colorful umbrellas, water proof bags and rain coats to get out of the closet. While the monsoons usher in a cooler, rain-drenched weather, it might wreck havoc on one's health. There is a steady rise in cases of viral infections during the monsoons. Cold, cough, sore throat, viral fever, allergies, diarrhea, and malaria are the common problems that affect people during this season. The sudden increase in infectious diseases during monsoons often leaves us baffled & wondering as to what might be the probable causes. The damp weather, followed by the humidity in the air is the key to the rise in instances of viral infection. The fast changing weather also makes a perfect breeding ground for bacteria and virus. The diseases primarily arise from water, air, mosquitoes and moulds. Cases of serious viral infection may be give rise to Gastroenteritis and Viral hepatitis- both of which are water borne. Gastroenteritis can be a painful ailment that causes digestive disorder & cramps. Viral hepatitis is a serious infection that results in yellow urine and yellow

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eyes, accompanied with high fever. Any symptoms of these diseases are to be treated as per a specialist doctors consultation. During this season, people can be prone to mosquito borne diseases like malaria, dengue fever and chickungunya. Malaria can be lethal, if left untreated. A bout of Chickungunya can cause severe joint pain, which can lasts for weeks and months. Dengue fever can also be very serious in certain cases. Although, an early detection & treatment can help treat the dengue better. Air borne viral infections are often mild usually causes minor infection in adults. However, elders & young children are more vulnerable to these infections & need to take proper care. Moulds growing on humid surfaces including our clothes and moist areas of the skin, is one problem that is frequently encountered during the season. However, mould induced infection are often mild in nature & can be treated easily.


EXPERT VIEWS

Prevention is better than cure: Listed are some preventive measures that will ensure that monsoons are an enjoyable experience. •

Drink only clean water. Use boiled water or water purifiers.

Use separate hand towels.

Cover your mouth and nose with a handkerchief while coughing or sneezing.

Use mosquito repellents and nets (dengue transmitting mosquitoes usually bite during day time, either early morning or late evening)

Keep your garments dry and keep aside the wet, soggy shoes to keep the moulds away.

Seek medical attention early

Consume freshly prepared food and avoid eating out as much as possible

Drink warm water every two hours; carry homeboiled water while travelling

Avoid visiting crowded places such as theatres or exhibitions.

Use hand sanitizers.

Cover your nose while travelling in bike / while seated next to window in bus or train.

Avoid getting wet in rain.

Parents must takecare of themselves, since they can transmit the infection to their children. The treatment: Infections during monsoons, usually starts with tonsillitis, cold and cough and gradually spreads to the rest of the body. Symptoms of viral fever are body and muscle pain, headache, joint pain, redness of eyes, skin rash and nasal congestion. Some people also experience nausea, vomiting and diarrhea. The treatment of viral fever is entirely symptomatic and it usually comes down after four or five days. HOME REMEDIES FOR VIRAL SYMPTOMS : 1.Adequate hydration by drinking lot of liquids 2.antipyretics and analgesics for fever and body pain. 3.Steam inhalation for nasal congestion and sinus pain. 4.Salt water gargle for sore throat.5. AVOID SELF MEDICATION WITH ANTIBIOTICS. Though it is highly contagious, the chances of it turning life-threatening are quite rare. If symptoms are severe or long lasting, visit your doctor to rule out any bacterial infection. Flu vaccines can often prove useful and one needs to take booster every year. By Dr M J Jayakanth, MBBS, MD Consultant Specialist at Apollo Clinics

Prevention for kids: Parents must keep their children away from those with infectious illnesses while playing or at school. Parents should ensure that their child’s nails are cut short to prevent accumulation of germs and dirt; ensure proper washing of hands and legs and provide nutritious food with a balanced diet. Keep your child indoors during the first rain of the season. This rain can be acidic and could cause skin problems. Young children are susceptible to frequent bouts of illness during the monsoons. Hence, it is advisable to keep the baby indoors till the weather stabilizes.

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DOCTOR SPEAK

Managing Asthma in Children

Dr. Rajiva Kumar Child Specialist, Muzaffarpur

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A

sthma in childhood is common and it can be serious. Most of the children in India are affected by asthma. You need to work out a plan for managing your child's asthma with your doctor. Understanding asthma People with asthma have sensitive or 'twitchy' airways (bronchi and bronchioles). When they are exposed to certain 'triggers' such as cigarette smoke or viruses, the airways become narrowed and this makes breathing difficult. The main ways the airways become narrow are: o the lining inside the airways becomes red and swollen o the muscles around the airways tighten o extra mucus may be made. Symptoms of an asthma attack include wheeze (noisy breathing when breathing out), a dry cough (often at night, early morning and during exercise or play), chest tightness and shortness of breath. Main causes of asthma It is not yet clear why some people get asthma, but asthma tends to run in families. A child is more likely to get asthma if a parent, brother or sister has asthma. Eczema and hay fever are also linked to asthma. If someone in the family has eczema or hay fever, a child is more likely to get asthma. Some research has shown that exposure to cigarette smoke before birth or soon after birth makes it more likely a child will develop asthma.


DOCTOR SPEAK

Children who have bronchiolitis in the first year of their life are more likely to develop asthma than other children, but it is not clear if the infection causes the asthma, or if the child develops bronchiolitis because he or she already is likely to develop asthma. Asthma can occur for the first time at any age. Trigger factors for asthma Colds and 'flu (viral infections) are the most common triggers of asthma attacks in young children (about 70% of attacks). Breathing in allergens is a trigger for some people with asthma, eg pollens, moulds, house dust mite droppings, animal hair and skin flakes, dust. Smoking or passive smoking . Smoke irritates the airways. Children who live with smokers are more at risk of developing asthma at a younger age. Chemical fumes and strong smells, eg household paint, sprays, perfumes. Changes in air temperature, eg going out into cold night air. Some foods, food additives and colourings, and some medications (eg aspirin). Emotional reactions, such as laughing. Asthma management The most important parts of asthma management are: o Learning as much about your child's asthma as you can.

o Teaching your child how to manage her asthma. o Getting the right preventive medicine, and reliever medicine to use if the child has an attack. o Working out what triggers the asthma and avoiding triggers as much as possible. o Recognising asthma symptoms and treating them early. o Using asthma medications correctly. An asthma action plan needs to be worked out specially for each child - the medications used and the way they are used depends on the age of the child, how bad the asthma is and how often the child gets an attack. Preventers need to be taken daily even when the child is well. They may take a few weeks to work. Relievers are used to treat attacks, as well as sometimes being useful to prevent symptoms, for example with exercise induced asthma. o If a child needs relievers more than about 3 to 4 times a week, the child needs to be checked by a doctor, and preventers may help control the asthma. Other medications such as symptom controllers, combination therapy, and steriods during a severe attack, may be needed. Using a spacer means that more of the medication gets down into the lungs.

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INTERVIEW

Guru Prasath Director Business Development / Marketing Messe Duesseldorf India Pvt. Ltd. What made you join exhibitions/events industry, and what did you do prior ? Luckily, I started off my career from the exhibition industry itself. I was attracted to the exhibition business because I loved the idea of connecting people and developing relationships. The exhibition Industry offered me the opportunity to bring buyers and sellers together for a faceto-face interaction. And I could do that on industry-leading events as well as start-up shows, some of which have since developed into must-attend events which makes me happy. Describe your exhibition journey, what observations have held true throughout your ascent to the role you hold today in Messe Dusseldorf India, & especially as a Project Director for Medical Fair India ? I started my exhibition career in 1995 as executive and worked my way up through various sales & leadership roles, handled some of leading large-scale exhibitions in multiple cities/countries until joining as Director -Business Development with Messe Dusseldorf India. Throughout, the exhibition journey has been exciting one as I was involved in various exhibitions- be it a launch or managing cluster of exhibitions portfolios & working with multiple project teams and so on. In the past, I had opportunity to work for leading exhibition companies in India /abroad as well, held key positions that in return helped me to understand different market characteristics/industry & exhibition life-cycle. Presently, I am responsible to manage MDI’s most important eventMedical Fair India- which is recognised as India’s No. 1 Medical Industry event. In addition to project management role, I add to my portfolio and expand my responsibilities

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to strategy & overall business development role for the company which I am looking forward. Throughout, I have found that a key to my success has been to always have a mentor, to whom I report & who taught and shared experiences to overcome challenges and difficulties. Not to mention, I love to work in a team & always had a great team. That way I have been able to learn and grow with each opportunity presented to me. In addition, I have a passion for exhibitions. I love the concept of the face-to-face meeting, particularly in an era that is very online-focused. I like to spend a lot of time developing programmes that enhance the customers’ experience and I have been lucky to play a key role in the past. Additionally, my relationships both internally and externally have kept me extremely loyal and passionate


INTERVIEW about what I do. I have longstanding relationships with our partners, associations, vendors, and these relationships have given me the opportunity to develop new business ideas, transact large sales, and help companies succeed. What do you wish to focus on as Director for Medical Fair India 2016 ?

importance in the global healthcare map & attracts thousands of exhibitors & visitors across various countries. The next Medical Fair India, shall run into its 22nd edition- thus making it as one the most reputable medical business event of its kind for healthcare professionals to converge, network & engage and do business all under one roof. Medical Fair India, has enjoyed an indomitable successful history so far, amongst Indian and global medical companies as the most As Director- Medical Fair India, I plan to focus on preferred platform to explore business opportunities continuing to deliver value to our exhibitors/visitors, growing our business and in turn, providing opportunities What the salient features of last held Medical fair India to network with important stakeholders on this particular 2015 ? What were your contributions in making it as industry. I strive to work with my team in India/Germany stand-out event of its kind ? and to be able to leverage on the best practices. We plan to bring in fresh concepts to enhance exhibitor participation The last held Medical Fair India 2015 was a smashing hit by & improve their business prospects at our event. all means. The last event set a record, in comparison with its previous editions held, on visitor attendance & overall What will be your strategy to strengthen & maintain the appeal exhibitor participation, special features & area brand “Medical Fair India 2016” as a leading event for occupancy. For the first time, special networking features like Medgate Today healthcare excellence Awards, focussed Medical business ? conferences on medical equipment & hospital infrastructure, The strategy is to be more outwardly focused with our enthralled the visitors. The visitor pre-registrations soared & exhibitors, associations & partners, be open minded, actual visitor attendance grew by 25%. Exhibitors expressed receptive to their ideas & to enhance our exhibitors’ their utmost satisfaction, in all respects. The results gave experience through Medical Fair event. Also using us much needed motivation to upkeep its standards. As for technology to further develop our event, and provide the contributions, I definitely owe to Stephan Kueppers- my our visitors/exhibitors with more efficient and effective colleague based in Dusseldorf who has a rich experience to ways to do more and more business & generate lead/work on our international medical shows worldwide contacts to increase business prospects from our event. - together we worked our way up to deliver a successful Medical Fair India. Can you tell me more about Medical Fair India event in Following recent Hospitalar’s acquisition in the global general ? medical event calendar, are we likely to see any Medical Fair India, is flagship brand of Medica- the acquisitions or consolidations within Medical event world’s largest annual medical event which our parent landscape, particularly in India ? company- Messe Düsseldorf Germany organises every year. “Medica”is a truly global brand and continuously growing its Although difficult to predict, I personally do believe that there are ways to grow in organically too, especially given a stiff market conditions like India & many medical conference based events are managed by Indian associations at a national level. We believe the exhibition industry is already at its maturing stage, and that shall present numerous opportunities for everyone in our business. The key will be to identify which metrics are appealing and to pursue on opportunities based on those decisions. Looking ahead, I believe clearly, market leading events, shall dominate and shall play a crucial role. Notwithstanding, the challenge for every exhibition organiser shall remain, to be more resilient to changing market dynamics, and continue to deliver ROI to our customers. What do you do in your spare time? Of course, I love spending time with my family. Get relaxed, learn new things which can help me to perform my work smart enough. w w w.medegatetoday.com July-August 2015

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DOCTOR SPEAK

Recurrent Headaches: When to See a Neurologist?

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eadaches are one of the most common health problems we experience in our daily lives. Given the high paced, stress-driven, unhealthy and addiction laden lives we lead, occurrence of headaches is not an uncommon phenomenon. Most of us experience headaches once in a while. While some pains abate on their own, others force us to gulp an over-the-counter painkiller.

Dr. A K Sahani

Sr. Consultant, Neurology, Indian Spinal Injuries Centre

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Headache is a non-specific symptom, and can arise due to several possible causes. It is often difficult to tell why you are suffering from a headache at any particular point of time. The causes may be anything benign or serious ranging from stress, skipping of a meal, sleep deprivation, fatigue or recreational drugs. Headache is common when a person is suffering from a viral infection or common cold. Often, headaches also occur due to an eye condition or vision problem. Getting your eyes examined and correcting your lens’s refractive index can alleviate such a pain. When a sinus becomes inflamed, often due to an infection, it can cause headache too.


DOCTOR SPEAK

Lack of awareness also means that the society remains indifferent and unsympathetic to the condition of the patients suffering from such a neurological disorder. Even family members may be disdainful or apathetic, often refusing to understand the condition. The question many ask is when shall a headache be reported to a doctor? Some of the serious conditions that may cause headaches of concern include infections such meningitis, brain tumor, stroke, brain hemorrhage (sub arachnoids hemorrhage due to rapture of Other factors associated with frequent headaches abnormal blood vessels), an inflammation include depression, stress or anxiety, sleep disturbances, of the blood vessels inside the brain, migraine or a head excessive weight and heavy dependence on stimulants injury. such as caffeine and nicotine. People who are addicted Here is when headaches should be taken seriously to smoke also experience headaches if they refrain from and reported to a neurologist: cigarettes or attempt to quit smoking. Medication overuse or rebound headaches are • If a headache occurs after a head injury, it has to be taken very seriously. In some cases, it might be just a another form of pain which happen to people who indulge minor concussion but it may also be an indication of in excessive consumption of painkillers. serious trauma inside the brain. Another common form of headaches is tension headaches. They exhibit in the form of a constant pressure • A headache associated with symptoms such as dizziness, loss of balance, numbness in limbs, blurred of tension in the head or the neck. They are sometimes vision or speech difficulty may indicate a brain caused by excessive stress, and resulting contraction of stroke. Such a condition needs emergency medical the muscles and nerves in the neck, back and head. help. More often than often, a headache once a while is not a serious concern, and can be cured by ensuring rest. • If headaches are becoming too frequent, they should be reported to a neurologist who will examine However, there are several instances when a headache you thoroughly and may put you under a CT scan or can be due to a more serious underlying cause, and needs MRI to rule out a serious issue. Frequent intense and medical intervention. long lasting headaches are often migraine. In India, people have a habit of taking headaches lightly and self-treating them with over-the-counter • A headache accompanied by nausea or vomiting should never be ignored. Some migraine patients also analgesics, even when the pain is recurring and experience nausea with throbbing pain. However, it causing discomfort and loss of productivity. In fact, we may also indicate a worrisome development inside come across people who have been living with chronic the brain. migraine for several years without seeking medical attention due to lack of awareness. In case of migraine, • If you suffer a new type of unexperienced, excruciating headache suddenly at any time in your more women than men suffer from intense bouts of pain, life, make sure you immediately visit a neurologist. and continue to believe them to be just another form of headaches. • People suffering from depression or severe anxiety Migraine headaches are caused by a complex interplay of nerves, neurotransmitters and blood vessels in the brain. By interfering with the normal functioning of the central nervous system, such headaches cause much discomfort in the body.

also experience headaches. When accompanied by a change in personality or behavior, listlessness, a tendency to cry or persistent fatigue, it is advisable to visit a doctor. You might be suffering from depression. w w w.medegatetoday.com July-August 2015

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EXPERT DOCTOR VIEWS SPEAK

Prolonged stress leads to multiple inner health problems Stress — just the word may be enough to set your nerves on edge. Everyone is stressed in some form or other. Some people handle stress effectively or recover from stressful situations quicker than others. Stress is good if it is a short term phenomenon and pushes you to achieve your goals or targets, but it is harmful, if it prolongs or becomes routine. Stress can be defined as a physical, mental, or emotional factor that causes bodily or mental tension. We usually tend to think that stress can lead to negativity, but that isn’t the case always. However, anything that puts high demands and forces you to adjust accordingly can be stressful. Stress may have adverse effect on your health, but one may not realize it. Chronic unrelenting stress has become so common in modern life; provoking feelings of hopelessness; what is usually termed as a defeat response.

When stressors are always present and the subsequent exposure to these hormones, especially cortisol for a prolonged period leads to a lowered BMI, increased fat storage and increases risk for hypertension, heart disease and stroke. Furthermore, stress also wrecks the immune system. During stress, cortisol suppresses the inflammation process and over a period of time the body develops resistance to cortisol. Additionally, cortisol and corticosteroids suppresses lymphocytes and puts the body at an increased risk of infection such as influenza and other diseases.

There are multiple ways to cope up with stress; which begins with identifying the sources of stress and dealing with it. Since stress has a direct impact on health, it is important to regularly monitor health parameters to make sure your vital organs are performing well. A typical Stress and emotions related to stress trigger chemical health package to monitor stress and its effects would reactions in the body and leads to increased fat storage, include tests to measure blood sugar, cholesterol, lipids, abdominal obesity, tissue breakdown, suppression of the cortisol etc. This tells you if you are at risk for heart disease, stroke and gives an overall indication of your immune system, increased risk for heart disease etc. inner health. The human body is wired to react to stress in a particular manner which helps you prepare for a situation. Imagine To conclude: “It’s not stress that kills us, it is our reaction a close encounter with a speeding car; this is when you to it”, Says Hans Selye, author of The Stress of Life. What encounter a perceived threat. The hypothalamus, which is your reaction to stress? is a small portion of the brain, sets off your body in to By Dr Sonali Kolte an alarm mode. A combination of nerve and hormonal General Manager, MedicoMarketing responses signals the adrenal gland to release hormones Metropolis Healthcare that includes Adrenaline and Cortisol. 52

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EXPERT VIEWS

NATHEALTH pledges its support to PM’s Initiative of ‘Digital India’

Healthcare IT Taskforce formed by NATHEALTH-NASSCOM Citizen Healthcare Portal, Mobile Apps, Digital Technology Trend will Shape Healthcare in India NATHEALTH, the apex Healthcare Body in India, digital mode, a patient at the primary health center in extended its support and appreciated Prime Minister Mr. a village can be connected to any medical specialist Narendra Modi’s endeavour to go digital. hundreds of miles away and diagnosed online. It can also be a powerful tool for real time disease surveillance Mr. Sushobhan Dasgupta, President, NATHEALTH which is needed to fight the risk of epidemics such as said, PM’s efforts to transform India into a connected Non Communicable Diseases, Tuberculosis, Trachoma, knowledge economy and offering world class services at Leprosy, Malaria. the click of a mouse through Digital India programme, is truly commendable. Initiative of using mobile and Mr. Anjan Bose, Secretary General, NATHEALTH said, internet strategies – such as telemedicine, doctors on call “Through our collaboration MoU with NASSCOM, and remote patient monitoring will help in improving the our vision is to leverage technology to address access of quality healthcare universally. healthcare challenges, in order to improve patient care. NATHEALTH-NASSCOM joint initiative will try to build Mr. Anjan Bose, Secretary General NATHEALTH said, linkages across multiple stake-holders in healthcare and using wearable and mobile technology will help educate information technology sectors. We will try to evangelize and engage citizens in healthy living and prevention of a new class of technology solutions and service delivery diseases…India has Mobile Penetration increasing at 3%, platforms that enhance healthcare access, affordability, Smartphones at 70% and Internet at 22%...Innovations availability and therefore support the government’s aim in ‘Digital Healthcare’ will enable solutions across the to achieve “Universal Health Coverage”. healthcare value chain. NATHEALTH and NASSCOM have formed a Joint Mr. Dasgupta also added that Telemedicine through Council (NNJC), comprising of top leaders in member Tele-Consultation, E-ICUs, remote patient monitoring, companies from both the institutions, representing lifestyle management through education tools will further respectively Healthcare and IT sectors. help in enhancing patient care to the next level. Through The Joint Council will focus on (1) Creation of Central IT Healthcare Platform, (2) Remote Healthcare, (3) IT Enabled Preventive and Chronic Care and (4) Healthcare Workforce. We aim to leverage digital technology for innovative solutions which will help both Healthcare and IT sectors grow further. Emerging technologies like cloud, analytics, pervasive presence of mobile telephony and broadband penetration has created new opportunities for both healthcare and technology sectors to collaborate and increase Healthcare quality, accessibility and affordability, informed Mr. Bose.

Anjan Bose

Secretary General Health Care Federation of India (NAT HEALTH)

As Digital India is an umbrella programme including several schemes for inclusive growth in multiple sectors through digitalization of services, it would help us to create self-sustaining models in healthcare that will enable the rapid growth of the services, by creation of digital infrastructure and service delivery through digital mode, added Mr. Dasgupta.

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INTERVIEW

“

Now medical facilities in India is as good, as anywhere in the European and American Countries. People are not going abroad rather than people are coming to India

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On Doctors day, What is your message for the doctors? My message to the doctors is that when they practice ,they should maintain their ethics in the practice.

How would you take India in terms of medical facilities, why still a lot of people are going abroad for better medical conditions? Now medical facilities in India is as good, as anywhere in the European and American Countries. People are not going abroad rather than people are coming to India, if you say especially for the advanced surgery for the cancer ,brain they are coming from all around south east Asian countries to India only. What is the success rate in the Cardiac surgery, and what are the possible future advancements that are likely to happen ? The cardiac success rate is very good, it can be compared with any part of the world because our techniques, our systems is as far as you can compare with USA, or any other European country. You have been awarded with the highest civilian honor for holding an expertise in the cardiac thoraic. How do you take this achievement? See this cardiac surgery, we have revolutionized and why I was awarded because we operated cardiac surgery on a very low cost, and with a very minimum facility in the government hospital long time back, when I was only 34 or 35 years of age. So I take this honor, that the government has recognized my expertise in the government setups. Do you really think that Cardiac surgeries are cost effective for the common man as the inflation is on the boom. Definitely it is a costly surgery, like for congenital heart disease, the government of India is helping them to get operation done in any government or private hospital, and it is reimbursed. So all the people who are suffering

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Dr. Jagdish Prasad

Director General, Health Services, Govt. of India

from the congenital heart disease ,and are below poverty line are helped by the government of India, and many states like Tamil Nadu ,Karnataka, Andhra Pradesh the government is giving the facilities to all poor people, and definitely in the private sector the cost is very high where the poor man cannot afford .But in the government set up and in other places like, West Bengal where we are giving the money to the centers, and they are using that money for treating, the poor patients free of cost. So now although it is costly but poor patients get the treatment freely. Any plans for establishment of medical colleges in India. What are the future policies that will be implemented in order to uplift the health and medical fraternity . Definitely number of medical students are much more high, and now we have recognized DNB, as a qualification for the teachers. Till our younger generation comes , and one thing for the higher post of professor ,we have to increase the age of retirement as the age has been increased in some states and the MCI has increased age in some states up to 60-70 years. So this has filled upmany gaps ,still there is a gap for the teachers at the moment, and this can be done only after increasing the pay scale of teachers ,so that they should come to college rather than going for practice. Any plans for establishment of medical colleges in India. What are the future policies that will be implemented in order to uplift the health and medical fraternity ? At the moment government of India is planning is to open 57 more medical colleges by upgrading the district hospitals So which ever district hospital has 300 or more beds ,we are giving money to convert them into a medical college .In the plan ,there is a provision to increase the number of medical colleges from 400 -459.


INTERVIEW Flawless Medical Engineering over the years Adds up more credibility inthe medical world. In India TuffT takes the lead.

I feel that the most important thing in any business is to satisfy a customer’s basic needs. Having designs, which are more beneficial to the end user. Kawal Arjani

Managing Director, TuffT Surgical Instrument

Tufft Surgical Instruments is now one of the leading establishments in India. The range of products includes General Surgery, Gynecology & Obstetric Surgery, Cardiothoracic & Vascular Surgery, Micro Surgery, Orthopedic Surgery, Ophthalmic Surgery, Neuro and Spinal Surgery, Plastic Surgery.

Accuracy and precision in instruments, and Quality of instruments have to be the best possible. We follow our own policies that are beneficial right from the manufacturing part to the end customer. It is very important to be truthful and justifiable on your product and we certainly follow that with our customers.

We have also reintroduced ourselves in the hospital consumables category with products like stethoscopes, sphygmomanometers, Medical Hollowware.

Do you made customize instruments according to doctor need and application?

We are participating in the biggest exhibitions and fairs globally, which includes MEDICA Germany, ARAB HEALTH Dubai and AFRICA HEALTH South Africa. We also participate in all the biggest exhibitions and fairs of India that includes MEDICALL and MEDICAL-FAIR INDIA.

Brief about you and your company? My Father Mr. Jaswant Singh started the company in the year 1932. For majority of the years we were into manufacturing of Hospital Furniture. I started the venture of Surgical Instruments with an aim of providing the best quality instruments in the market.

We do customize instruments according to the needs of the doctors so that surgeries can be performed more easily and risk free. Any shape and size can be customized according to the required specifications. Tell us about your presence in India as well as abroad?

We wish to expand our hold into the domestic market and to lead India to the global market as well. We have a As your company is a pioneer wide network throughout the globe in surgical Instruments. Please today with more than 100 dealers and elaborate how you are different distributors all over India whereas 10 from other Manufacturers? dealers abroad. We at Tufft Surgical Instruments Do you hold any certification or work on our DAQ policy i.e. “Design, awards for best quality ? Accuracy, Quality”. • ISO 90001:2008 I feel that the most important thing in • ISO 13485:2003 any business is to satisfy a customer’s • CE basic needs. Having designs, which • WHO GMP Compliant are more beneficial to the end user.

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PRODUCT Line

Paradigm shift in demand for Anaesthesia Workstations Manual ventilation modes. The advanced versions offer an addition of PSV – Pressure Support Ventilation, SIMV – Synchronized Intermittent mechanical ventilation with Pressure / Flow triggers, Spontaneous mode of ventilation. The workstations are offered with our Meditec Pisces vaporisers, which are suitable for delivering Halothane, Isoflourane, Enflurane and Sevoflouraneanaesthetic drugs. The vaporisers offer a drug delivery range starting from 5% to 8% and come with a choice of drug filling options. Aditya Kohli The vaporisers are accurate and precise and are designed to Director – Marketing & Sales, compensate for variance in temperatures and flow. Allied Medical Limited

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he last decade has witnessed a paradigm shift in the demand for Anaesthesia Workstations. Having a good reliable Anaesthesia Workstation with Temperature compensated Anaesthesia Vaporisers and in-built ventilation has now become the new norm. We are witnessing increased number of customers upgrading from existing boyles type basic anaesthesia machines to quality Anaesthesia Workstations packed with safety features. Our Range of workstations is designed in such a manner to offer a range of customizable features to suit varied budget requirements depending on the customer needs without compromising on the safety standards of the equipment. Every hospital is now focused on improving its patient safety and comfort standards and upgrading conventional Anaesthesia Machine to Anaesthesia workstation is the first step towards achieving that goal. The safety features offered by Anaesthesia Workstations are at a huge advantage and substantially minimize chances of any accidental incidents during Anaesthesia. All our workstations are equipped with a twin station manifold for mounting two selectatec type temperature compensated anaesthesia vaporisers with interlocking safety, an anti hypoxic system, an inbuilt integrated ventilator with direct switching controls from the circle absorber system and integrated patient alarms. The display screens are offered in a series of sizes and touch / non- touch variants to meet varied customer requirements. The ventilators offers a choice of Ventilation modes comprising of CMV – Continuous Mandatory Ventilation, PCV - Pressure Controlled Ventilation, SIMV – Synchronized Intermittent mechanical ventilation and

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The workstations are offered with a choice of monitoring options starting from basic monitoring of ECG, NIBP, SP02, RESP and Dual Temperatures. The monitors offer a number of upgradeable features such as EtC02 monitoring, Anaesthetic Gas Monitoring, Invasive blood pressures, Cardiac Output, Depth of Anaesthesia Monitoring and many others used for advanced anaesthesia monitoring.



INTERVIEW

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Maintaining a Legacy of Medicall is Strenuous, but passion and commitment makes a way Desribe be your journey and what was the driving force you in the course of time?

K. Sundarajan Project Director, Medicall

The journey was absolutely fantastic .I am associated with medicall from a long time, and every year we look forward to make it better ,and of course some ups and downs came in the journey but it was a learning lesson as it’s a part of life. Now it feels really good to be part of this massive event which is a gateway for the medical professionals and entrepreneurs to understand the Industry needs and also provides them insight about the whole business as it gives a common platform .The driving force for me was the needs and the potentials of the country which I observed in my journey and it kind of pushed me to carry on further. What is the mantra of success for you .As a director there must be loads of responsibilities .How do you deal with it.? We should learn from our mistakes and always try to make it better next time .There is a saying which I follow in my life that” if someone corrects you and you feel offended then you have an ego problem”. So I never felt offended when someone corrected me or advised me. As a director there are lot of responsibilities but if you have passion and you really enjoy what you do, then I think it s easy for a person to tackle it, so I always prioritize work in my professional and personal life and being a project director of Medicall means a lot to me, So proper management and addressing the demands at the right time, like allotting the right portfolios from the talent pool for specific job is a way to deal with it.

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INTERVIEW 3.Medical is a massive platform for healthcare professionals. what are your expectations from this event? Indeed it is a big platform in india for healthcare professionals .As I said ,I always try to make better every time, and of course the expectations are obviously high this time too. We are putting in the best efforts in order to create awareness and to bring in the potential clients .There are lot of people coming in this time across globe to visit Medicall-Chennai so fingers crossed . We are also coming to Mumbai in Big way from 9-11October 2015 and we are getting very good response from Industry. Do you think that this event would be acting as a Catalyst in the business arena of medical fraternity? Ans 4 .Yes, I am sure it would be acting as a catalyst .we are doing this event on a big scale ,and the established entrepreneurs and the potential entrepreneurs, who want to establish the business & brands in healthcare industry ,will be getting a broad insight .The market is not saturated yet and the needs and demands of india are very high ,so this event will surely cater the entrepreneurs and hopefully we will see some action in Business arena. What do you do in your spare time. Well being honest ,I am a singer so I sing when I get free time Whats your message for the aspiring entrepreneurs in the healthcare industry ?How to kick off a business particularly in the Healthcare? A ns 6. I would like to say ,it’s a massive industry and a lot can be done on business grounds .People should attend event like this ,In order to figure out the needs of the industry .They should build relationships with industry experts and leading entrepreneurs. So Medicall provides this platform, from where smart people can really fetch something substantial and productive .This will also give them holistic view of the operations, taking place in india and abroad. So I think this will help them for establishing and growing his business.

Dr. S. Manivannan Joint Managing Director, Kauvery Hospital Founder & CEO Medicall

“What drives us is nothing but passion, because we all come from ordinary middle-class families without any medical background. We are the first-generation doctors in the family. We wanted to prove something to the society and also give something back to the society. That’s why we started our hospital in Trichy, our hometown, though we had opportunity to start in Chennai or travel abroad. We are very happy that at Trichy we are able to offer tertiary care therapies and treatments to our people, which were earlier done only in a bigger city like Chennai. Now, a person of Trichy doesn’t travel to Chennai or Coimbatore for taking any tertiary care. This is the greatest satisfaction which an entrepreneur can have, more than any money or fame which they get.More than that, it really gives a lot of happiness to our parents, seeing their children doing more than what they’ve imagined and doing better to the society than what they’ve done.”

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DOCTOR SPEAK

Are you a victim of misdiagnosis? Heart rhythm disorders, also called cardiac arrhythmias, occur when there is a malfunction in the heart’s electrical activity. As a result, the heart can beat too quickly, too slowly or irregularly. Arrhythmias could be indicative of an underlying heart condition and a misdiagnosis could prove to be life threatening. Diagnosing an arrhythmia and its cause may be delayed or missed in cases where the symptoms may not be too severe for a person to seek medical care. In addition, some symptoms of arrhythmia, such as palpitations and lightheadedness are similar to symptoms of other conditions like stress, anxiety, panic attack or perimenopause.

External Cardiac Monitor (ECM) Often the symptoms are not persistent and may not happen in presence of a doctor making it extremely difficult to diagnose. An External Cardiac Monitor (ECM) has the capability to monitor a patient’s heart rate for up to 30 days. These devices monitor, record and store cardiac data and a very convenient tool to use. It is stuck on the patient’s chest and the patient can do all activities without any hindrance. Incase an abnormal rhythm is detected, it is immediately transmitted to the patient’s doctor and he / she will be called for a follow-up. Thus there is a higher chance of providing a more accurate diagnosis to patients with infrequent symptoms.

However in cases – when a patient experiences recurrent fainting, palpitations, unexplained stroke – arrhythmias Importance of Cardiac Monitoring can be serious and potentially life threatening. A wrong  Because abnormal heart rhythms and their diagnosis may lead to unnecessary or delayed treatments, accompanying cardiac symptoms often come and go physical and emotional suffering and could be a threat to in a transient manner, they may be difficult to detect. patient safety.  Tests such as ECG (electrocardiograms) only allow a physician to look at the heart’s activity at one point in time, and a patient may be at risk for future symptoms or events that were not detected at the time the test was administered.

 To determine the cause of recurrent fainting, palpitations or unexplained stroke, a patient’s heart must be monitored over time so his or her physician can diagnose the disorder accurately.  External Cardiac Monitor (ECM) is a simple and convenient tool that monitors the patient’s heart activity continuously and immediately alerts the doctor incase of a rhythm disturbance.

Dr Aparna Jaswal

Senior Consultant Electrophysiologist, Fortis Escorts Heart Institute 60

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Accurate and timely diagnosis of arrhythmias is crucial to direct therapies that can make a significant impact on patient care.


DOCTOR SPEAK

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THE PROBABLE ISSUES OF DISCUSSION

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75 th

The Association of Surgeons of India

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CLASSIFIED EXPERT Update

Ambulance Equipments

diagnostic & lab products

Tufft

Shree Balaji surgical pvt ltd A/002, Ruchi CHS, Grd Flr Devidas Lane Borivali (W) Mumbai - 400103 M: 9820430338, E: sbsjaipur@gmail.com

ANESTHESIA EQUIPMENTS

bDS

biogene Diagnostics & Surgicals

Allied Medical Ltd.

T: 0124-4111444 akhand enterprises

G- 12, Shivlok House 1, Commercial Complex, Karampura, New Delhi- 110015 9350445559, 9717445559 akhandenterprises@gmail.com Medion Health Care Pvt Ltd

201, Shiv Industrial Estate, K.B.B. Marg Marg , Chinchpokli (E),Mumbai-12, M:9987642222 sales@medion.co.in

Autoclave & Sterilizers Jaiveer Surgical emporium

1570, Bhagirath Palace, Delhi-110006 T: 011- 23866065, 2386066, M: 9810880087 jainco.jain@gmail.com Creative Healthtech Pvt. Ltd.

M: 9811339989 Drager Medical Pvt. Ltd.

T: 022-40843826

Deals in:

Diagnostic Kit, Elisia Range, All Rapid Range, All Surgical Goods, Glass Wear, Plastic Wear, Lab Equipment, Laboratory Chemical Reagents, Dental lab Materials, Medical Equip., Scientific Equipment, Dental products & Medical Disposable Range Flat No. D-337, Ground Floor, Pocket - 11, DDA Janta Flat Jasola, New Delhi - 110025 E-mail: bdsurgicals786@gmail.com

Mob.: +91-8826920507, 9717085785

Disposable

GITA HOSPITAL SUPPLIES House of Hospital & Disposable Clothings

Surgeon Gown Suits, Caps, Face Mask, Patient Kurta-Pyjama, etc.

Ph.: 011-23860175, M: 9810370662

Sho-47, Naraina Bazar, Near Fountain, Chandni Chk, Delhi-6

Email: manojvtuli@gmail.com Hitex healthcare

A-402,Laxmi sadan,Thakur Village, Kandivali Mumbai 22 28860782 Shree Balaji Surgical pvt ltd

1-B-30,Lalita Shashtri Nagar, Behind Kalpatru Shopping Centre, Jaipur-16 T: 0141- 2309675

Saras Life Solution

ECG Equipments

M: 9923455413 Haribharath Equipments Pvt. Ltd.

T: 022-25666869

Blood Pressure Apparatus

S No. 16 , Navghar Bldg 59/ 60, Poonam sagar Complex Mira Road (E) Mumbai 401107 M: 9967064947 Nasan Medical Electronics Pvt. Ltd.

Rangoli Ist floor.,opp Karve Statue Kothrud Pune-411038 M: 8237032389

Remi Sales And Engineering Ltd

Healthware Pvt. Ltd.

T: 022- 40589888 Sanlar Imex Services Pvt. Ltd.

M: 9833192894

Defibrillator Equipments Medical Solution

Endoscopy Instruments

serene Tower 8-2- 623/A Rd No. 10, Banjara Hills Hyderabad -500034 T: 040-23318229 Helios Endovision

1/1, Sahkar Niwas , Tekri Bunglow, nr.3 Petrol Pump Old Agra Road, Thane- 400602 M: 9820276976

98873699736

Om Surgicals

Headlines

65, Unique. Est., Nr.Jammunadas, Opp jawahar Talkies, Mulund (W)Mumbai-400080 T: 022- 25670626

diabetic care Products

Anand Bhuvan Ground Floor 84-A, Princess Street T: 022-66379370 76

Hygeia Incorporation

M: 9324152433

Lab Hosp International

ENT Equipment Instrument

www.m e d e g a t e t o d a y. c o m November-December 2014

Surgical house,44,Mission compound,Ajmer Road,Jaipur T: 141 2373125, 2368568

GLOVES Shree Balaji Surgical Pvt. Ltd. A-002, Ruchi CHSGround Floor, Devidas Lane Borivali (W), Mumbai 400103 Ph.: 022- 28954442 Nulife Global Medical Devices Pvt ltd

B6,Byculla Service Indl. Premices, D.K. Marg, Sussex Road,Byculla, Mumbai-27 T: 2374 8371/2/3

HEALTHCARE PRODUCTS Shree Balaji Surgical Pvt. Ltd. A/2, Ruchi CHSGround Floor, Devidas Lane Borivali (W), Mumbai 400103 Ph.: 022- 28954442

HOME CARE Easy Care Group

4th Floor Shugar House, 93/95, Kazi Syed Street, Masjid Bunder (W) Mumbai 03 T: 02223450133 E: info@easycareglobal.com Nulife Global Medical Devices Pvt ltd

B6,Byculla Service Indl. Premices, D.K. Marg, Sussex Road,Byculla ,Mumbai-27 T: 022-2374 8371/2/3 Shree Balaji Surgical pvt ltd

1-B-30,Lalita Shashtri Nagar,Behind Kalpatru Shopping Centre, Jaipur-16 T: 0141- 2309675


CLASSIFIED Update

HOSPITALS (Multi Speciality) Cygnus Hospital

1211,Tower-2, Pearls Omaxe,Netaji Subhash Place, New Delhi-110034 T: 011 42488393 Fortis Escorts Heart Institute & Research Centre

Okhla Road, New Delhi-25 M: 91 11 4713 5000

Manaipal Hospitals

98, HAL Airport road, Bangalore-560 017 T: 080 - 2502 4444/3344 Pushpawati Singhania Research Institute

Press Enclave Marg, Sheikh Sarai, Phase-II, New Delhi – 110 017 Tel: 011 30611900

HOSPITAL CONSULTANCY

Hosconnn

operation theatre Light

Hospital Garments Kaustubh Hospital Garments

Magnatek Enterprises

4- 401, Vanrai Colony , Opp Nirlon, off W.E. Highway Goregaon (E)Mumbai-400065 M: 9869051352

97, SVC Indl Est., Balanagar, Hyderabad-500037

ICU Equipments

T: 040-65501094

Rehabilitation Product &AIDS

Philips India Ltd.

9th Flr, DLF, 9b , DLF, Cyber city, DLF Phase- 3 sec 25, Gurgaon-122002 T: 0124- 4606000

MOdular- Operation Theatre

Vissco Rehabilitation AIDS Pvt. Ltd.

517, Tulsiani Chambers, Nariman Point Mumbai-400021 T: 022-43330300

Sai Sumeet Appliances

Medical Equipment

Hyderabad M: 08099119595

Monitoring Equipments & Accesso Afford Medical Technologies Pvt. Ltd.

230, 2nd Main Road, Sainikpuri Secunderabad-94 T: 040-32908880

Technocare Medisystems

C/1310-11,New Bombay Market, Umarwada,Surat- 395010 T: 261 2332042,6569308

6, Chaithanya Complex Site 1, 17th Cross, Sir MV Nagar T.C. Palya Main Road, Bangalore M: 9845208778, Email: info@hosconnn.com

Drager Medical Pvt. Ltd.

Gold line Business Centre, Link Road Malad (W) Mumbai-400064 T: 022- 40843826

BIO-X

DDF Consultants 501, B-9, ITL Tower, Netaji Subhash Place, Pitampura, New Delhi-110034

Medion Healthcare Pvt. Ltd.

(w) Mumbai-400054 M: 9820355995

T: 011-47400500

201, Shiv Industrial Estate, K.B.B. Marg Chinchpokli (E) Mumbai-12 T: 022-23771737

Hospiteck Healthcare Consultancy

Nihon Kohden India Pvt. Ltd.

Bangalore T: +91-9739708532 Six Sigma Star Healthcare Pvt. Ltd.

New Delhi T: 011 25324000 E-mail: sixsigmahealthcare@gmail.com

Health care Institution Global Institutte of Healthcare Management

6 sigma house, 10A, Phase -1, Najafgarh New Delhi-43 T: 011 2532 4000,4001

HOSPITAL FURNITURE Godrej & Boyce Manufacturing company ltd.

Pirojshanagar, Vikhroli, Mumbai- 400079 T: 022- 67965656 Jaiveer Surgical Emporium

1570, Bhagirath Palace, delhi-110006 M: 9810820087 Janak Healthcare Pvt. Ltd.

kalpataru Point, Unit No. -12 1st floor, sion (E) Mumbai-400022 T:022- 49153000

Shoes Cover Dispenser 5th floor, Span center, South Avene Santacruz

Software and IT Solution

308, Tower- A, Spaz Edge, Sector- 47, Sohna Road Gurgaon- 122002 T: 0124-4931000

Neonatal Pediatric Intensive c Bird Mediteck

109, 110, NidhiIndl Est, Shankar Industrial Complex No. 2, Waliv, Vasai, Thane-08 T: 0250-3212729

operation theatre equipment

Schrack Seconet AG

T: 124 414150 Kodak Alaris

www.kodakalaris.com

SURGICAL BLADES Ribbel International Ltd

20th Mile, Jatheri Road, P.O.RaiNear Rai Industrial

Agora Climate Control system

Area Sonepat Haryana 131029

Unit No. C-1/2/3/, Sagar Sangam Ind. Est., Sativali Vasai (E) Thane-24 T: 0251-2872193

M: 8053111016, 8053111011

UROLOGY

Bird Meditech

109, 110, Nidhi Ind. Est., Nh No. 8, waliv, Vasai (E) Mumbai- 401208 T: 0250-3212729

97, SVC Indl Est.Balanagar, Hyderabad-500037 T: 040-65501094

Nurse Calling System Mumbai, India. Tel : 91-022-23094416, 23004930 E-Mail : medisystems@gmail.com

20th Mile, Jatheri Road, P.O.RaiNear Rai Industrial Area Sonepat Haryana 131029

Magnatek Enterprises

CR Medisystems Pvt. Ltd.

Ribbel International Ltd

M: 8053111016, 8053111011, sales@ribbel.com

X- Ray Equipment Allengers

S.C.O 212-213-214, sector 34,Chandigarh - U.T 160 022 (India) T: 172 3012280-84

w w w.medegatetoday.com November-December 2014

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